Integrating U.S. embassy visits into global health education: student reflections on diplomacy-focused experiential learning

BACKGROUND: U.S. embassy visits offer a unique opportunity to examine the intersection of diplomacy and healthcare yet are rarely incorporated into health professions education. This study examined student reflections following a U.S. Embassy visit in North Macedonia to inform the integration of diplomacy-focused experiential learning into global health curricula. METHODS: Twenty-one Ohio State University undergraduates (12 females; mean age=19.48±0.60 years) participated in an experiential learning activity at the U.S. Embassy-Skopje, North Macedonia, which included discussions with embassy personnel on diplomacy and healthcare delivery within a diplomatic setting, as well as an Embassy Health Unit tour. Immediately following the visit, students completed a structured written reflection describing a meaningful or surprising aspect of the experience and its influence on their understanding of diplomacy, healthcare, or international collaboration. Reflections were analyzed using Braun and Clarke's reflexive thematic analysis. Themes were developed through iterative coding and refinement, with the second author independently reviewing the thematic framework to confirm interpretations and achieve consensus. RESULTS: Reflexive thematic analysis identified three major themes-Expanding Conceptions of Diplomacy and the U.S. Foreign Service, Recognizing Healthcare as a Diplomatic Enterprise, and Broadening Professional Identity through Exposure to Global Health Careers-each comprising two related subthemes. DISCUSSION: Student reflections highlighted adaptability, resilience, cross-cultural communication, teamwork, and flexibility while revealing progression from knowledge to understanding to professional identity. The embassy visit expanded students' understanding of diplomacy while introducing previously unrecognized career pathways. Drawing on these findings, we propose a conceptual framework comprising four interconnected learning domains, suggesting that embassy visits provide a valuable component of global health education abroad.