During NCTTP’s 16th Annual Symposium on March 18, 2024, Triveni DeFries, MD MPH, Emilie Folsom, MPH, Eleanor Emery, MD spoke on “The Forced Migrant Crisis: The View from the Front-Lines.”
 

Abstract

Background
The Asylum Medicine Training Initiative (AMTI) launched in 2022 as a collaboratively developed, peer-reviewed, open-access, online course in asylum medicine based on the Istanbul Protocol. The curriculum (www.asylummedtraining.org) teaches health and human rights professionals to conduct forensic medical and psychological evaluations of survivors of persecution applying for humanitarian protection.
 
Methods
Data analytics from SquareSpace were used to determine the number and composition of unique visitors to the website. Data from pre- and post-course assessments was extracted into Excel and analyzed using an unpaired T-test to explore participant backgrounds and changes in knowledge and attitudes following curriculum completion.
 
Findings
Over the first year (10/1/22 – 10/1/23), 12,190 unique visitors from over 80 countries accessed the website, 1,191 registered for the course, and 496 completed the post-course assessment. Performance improved significantly on the knowledge-based assessment (76.5% to 86.5%, p<0.0001). 95% of individuals who completed the curriculum agreed it was effective in introducing them to forensic medical evaluations, and 95% would recommend it to a colleague.
 
Conclusions
An asynchronous online curriculum can be used to deliver effective instruction on asylum medicine to a diverse group of learners with high self-reported satisfaction. Next steps are to understand how participants translate this training into practice.
 

Authors/Presenters

• Triveni DeFries, MD, MPH is an expert clinician and trainer on medical evaluations of asylum seekers and survivors of torture and ill-treatment. She is an Assistant Professor at University of California, San Francisco Department (UCSF) in the Division of General Internal Medicine and a faculty affiliate in the Institute of Global Health Sciences. She is a physician who is board-certified in Internal Medicine and Addiction Medicine. She completed medical school, residency, and fellowship training at UCSF. She practices primary care and addiction medicine at San Francisco General Hospital. She directs the UCSF Human Rights Clinic where she performs forensic medical evaluations for people seeking asylum in the United States and teaches learners and clinicians. She serves as the Director for the UCSF Health & Human Rights Initiative. She co-founded the Asylum Medicine Training Initiative and has collaborated with Physician for Human Rights, Synergy, and other experts to increase the capacity of clinicians to perform documentation of human rights abuses using trauma-informed care and the Istanbul Protocol. Her special interests are in immigrant health, human rights, and addiction medicine.
• C. Nicholas (Nick) Cuneo, MD, MPH is an assistant professor of Pediatrics and Medicine at the Johns Hopkins University School of Medicine with a joint appointment at the Johns Hopkins Bloomberg School of Public Health, where he is affiliated with the Center for Public Health and Human Rights and the Center for Humanitarian Health. In addition to his work as the Medical Director of the HEAL Refugee Health and Asylum Collaborative, which he co-founded, he works as an academic hospitalist for children and adults at Johns Hopkins Hospital and Johns Hopkins Children’s Center. Nick has extensive global health research and program management experience, particularly in Haiti, where he was a Doris Duke International Clinical Research Fellow, and South Africa, where he was a Fulbright Research Fellow in Public Health. He is a graduate of the Harvard Brigham & Women’s Hospital/Boston Children’s Hospital Medicine-Pediatric Residency and served as chief resident for the Doris and Howard Hiatt Residency in Global Health Equity at Brigham & Women’s Hospital. He earned his B.S. in biology and anthropology at Duke University, his M.D. at the Johns Hopkins University School of Medicine, and his M.P.H. in clinical effectiveness at the Harvard T.H. Chan School of Public Health.
• Eleanor (Ellie) Emery is an internist with the Department of Internal Medicine at Northern Navajo Medical Center and an Instructor of Medicine, Part-Time at Harvard Medical School. Her work includes clinical, advocacy, and research efforts focused on improving access to high quality, trauma-informed care for underserved communities, including on Navajo Nation where she lives and practices clinically. Ellie has expertise in conducting forensic medical evaluations for people seeking asylum in the U.S. and has founded and led asylum clinics at Weill Cornell Medical College, Massachusetts General Hospital, UCLA, the University of New Mexico, and Cambridge Health Alliance. She co-leads the Asylum Medicine Training Initiative, a national working group of 80 experts from over 40 institutions that developed a virtual, peer-reviewed introductory curriculum featuring best practices in asylum medicine based on international standards. Ellie also serves as the Program Director of Asylum Medicine Education at the Cambridge Health Alliance’s Center for Health Equity Education and Advocacy, and in this capacity developed and co-leads an interdisciplinary, year-long elective course in asylum medicine for CHA residents.
• Emilie Folsom, MPH is a public health professional with specialization in refugee health and humanitarian crisis settings. She is the Program Manager for the Asylum Medicine Training Initiative. She also currently works at the HEAL Refugee Health & Asylum Collaborative as the Forensic Evaluation Clinic Program Coordinator. Emilie has served as a program manager and project coordinator in supporting recently resettled refugees and asylum-seeking families along the U.S.-Mexico border. Emilie is originally from San Diego, California and received her Master of Public Health from the Johns Hopkins Bloomberg School of Public Health.