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Learn about Maslow's social stage in the hierarchy of needs, apply the social stage to your life and experiences, and test your knowledge with a quiz.
Add important lessons to your Custom Course, track your progress, and achieve your study goals faster. IntroductionMedical education can play an important role in fostering future physicians’ sense of social responsibility and engagement with emerging community health needs1-4.
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It’s unarguable that human nature reveals a continuum of behaviors ranging from the most wretched to the sublime, at times bordering on the saintly. At the righteous end of the spectrum is our propensity for empathy, a trait deeply rooted in our primate heritage. Current guidelines highlight healthcare professionals' key role in responding to human trafficking, emphasizing the importance of medical education in raising awareness of trafficking. Human trafficking is a significant social justice issue and an international human rights violation.
Abbas Raza, Sughra Raza, Margaret Scurlock, Shahzia Sikander, Maria Stockner, and Hartwig Thaler. Empathy — putting oneself in another’s emotional and cognitive shoes and then acting appropriately — is now an incandescently hot topic, virtually a cottage industry of books, articles, and YouTube videos.
Marco Iacaboni, one of the world’s recognized authorities on the neuroscience of empathy, argues that the discovery of mirror neurons, the neurons responsible for empathy, is “so radical that we should be talking about a revolution, the mirror neuron revolution.” Why? Objective: To assess pre-clerkship medical students' awareness of human trafficking and attitudes towards learning abouttrafficking in the medical curriculum at Canada's largest medical school. The United Nations defines human trafficking as the recruitment, transportation or receipt of persons for the purposes of exploitation in forced labour, forced prostitution, or other forms of slavery, usually involving force, threat or deceit5.
Because of the profound implications for how we think about both individuals and the future of our endangered planet.
Methods: An anonymous, classroom-based questionnaire was designed, piloted and administered to first- and second-year medical students at one large Canadian medical school with a diverse student population.
While it is not possible to accurately estimate the global prevalence of human trafficking due to its covert nature, the United States Department of State provides narratives for the prosecution, protection and prevention of trafficking in both developed and developing countries across Asia and Pacific, Africa, Europe, North and South America6,7.
He is a licensed clinical psychologist who specializes in behavioral medicine with a specific focus on headache prevention and management.
The questionnaire sought demographic data and information on students' self-perceived awareness of human trafficking and interest in learning about trafficking and other community health issues. Trafficking is a truly global problem.Current literature strongly emphasizes the unique role of healthcare professionals in responding to human trafficking8-12 and the healthcare needs of trafficked persons13-20.
His research is focused on creating self-management models for chronic disease that can be implemented in the primary care setting. Healthcare professionals have a particular responsibility to identify and advocate for trafficked persons because healthcare professionals are often the only professionals that trafficked persons will encounter under captivity11.


Currently, he has a grant from the National Headache Foundation to create an Internet-based headache self-management program using tailored health communication and another from the National Institutes of Health (K23) to conduct a randomized controlled trial to evaluate the efficacy of the intervention. The United States Department of Health and Human Services (DHHS) provides educational resources for healthcare professionals about human trafficking, which emphasize that healthcare professionals occupy key positions for intervening on behalf of trafficked persons21.As multiple governmental, non-governmental and academic agencies consider health needs of trafficked persons a priority issue, physicians should likewise consider addressing this issue in their educational and professional activities. He is also interested in addressing potential cultural disparities that exist in headache care. He is a member of the Society of Behavioral Medicine, American Psychological Association, American Headache Society, and National Headache Foundation. While students' responses indicated that they prioritized other social issues, a majority of participants (76.0%) thought that trafficking was important to learn about in medical school, especially identifying trafficked persons and their health needs. Not surprisingly, one study reported that only 3% of emergency medicine health professionals had ever received training in how to respond to human trafficking22.The purpose of this study is to assess awareness of human trafficking among pre-clerkship medical students of one Canadian medical school and assess their attitudes towards learning about human trafficking in the medical curriculum.
Conclusions: These medical students of one Canadian medical school demonstrated limited familiarity with the issue of human trafficking but largely felt that they should be taught more about this issue during their medical education. These data from medical students are intended to inform medical educators as well as the organizations that are developing educational resources for healthcare professionals.MethodsA questionnaire was designed to evaluate medical students’ familiarity with the issue of human trafficking and their attitudes towards learning about human trafficking. The study was approved by the Office of Research Ethics, University of Toronto. ParticipantsThe study was conducted at one large Canadian medical school. First- and second-year (pre-clerkship) medical students were invited to participate in a brief questionnaire administered in the classroom. Students received information sheets about the study along with the questionnaires, and participation was completely voluntary and anonymous. Students did not receive compensation for their participation, nor did participation affect their academic standing in any way.Questionnaire Design and Data AnalysisNo validated questionnaire existed in the literature to evaluate students’ awareness of and attitudes towards human trafficking.
We designed a questionnaire composed of questions to target students’ self-perceived awareness of human trafficking and attitudes towards learning about human trafficking and other community health issues, for comparison (Appendix A). The questionnaire was piloted with a semi-structured focus group of four pre-clerkship medical students and was modified based on feedback from the group.
Focus group participants individually completed full questionnaires and then the group reviewed each item. Less than 5% had learned about human trafficking through their extracurricular activities during medical school, and no participants had learned about human trafficking within the medical curriculum.
A majority of participants (88.9%) felt that they were not familiar with the signs and symptoms that might help them identify a trafficked person. While human trafficking ranked lowest on the list of community health issues, a majority of participants (76.0%) still perceived human trafficking as important or very important. Specifically, when asked to evaluate the importance of learning objectives about human trafficking, over 85% of participants thought that it was important or very important to learn about the identification and health needs of trafficked persons (Table 3). A majority of students thought that it would be unlikely to encounter a trafficked person in a clinical setting in Canada, which is a misconception. Human trafficking is an increasing problem that crosses international boundaries in both developing and developed countries6,7, and is thus relevant in countries across the world. Trafficked persons may fear reporting their victimization because of their immigration status, psychological dependency on and fear of captors, and distrust of local authorities, so it becomes especially important that healthcare professionals recognize signs and symptoms in a patient that suggest trafficking24,25.Medical students should be aware of the complexity and severity of healthcare needs of trafficked persons15.
Trafficked persons require immediate attention for acute illnesses and longer-term care for physical and psychological problems that stem from pre-trafficking abuse and from violence experienced while being trafficked16,20. Physical problems include sexually transmitted infections13,14,18,19, food or sleep deprivation, injuries and compounded physical symptoms15,16.


Trafficked persons are also at higher risk of mental health problems, such as anxiety, depression, attempted suicide or post-traumatic stress disorder16,17.Healthcare professionals can help care for trafficked persons as they are rescued and must make difficult legal and immigration-related decisions16, and over the long run when they reintegrate into free society and rebuild their lives. Furthermore, medical students and physicians can use their unique position as health advocates to educate young potential victims in both developed and developing countries about the hazards of trafficking.
In particular, the US DHHS offers a useful learning package on trafficking for healthcare providers21. The International Organization for Migration also presents detailed guidelines for healthcare professionals on caring for trafficked persons26.Encouragingly, most medical students at our institution felt that it was important to learn more about human trafficking. Introduction of human trafficking into the medical curriculum can follow the examples of issues like domestic violence or poverty that have already successfully been included in medical curricula through novel educational programs27-30. At our institution, child abuse, domestic violence and poverty are taught in the medical curriculum, so it is not surprising that participants in our study chose these issues as the top three most important community health topics.
Information about human trafficking can be integrated into the community health curriculum, especially when issues such as domestic violence and child abuse are discussed. However, education about domestic violence does not sufficiently cover education about human trafficking, as human trafficking is an issue with additional layers of complexity9.LimitationsThere are several limitations to this study.
Firstly, this study was performed at one medical school, which weakens its generalizability. As 30.0% of eligible students did not participate, questionnaire responses could be biased, possibly with an overestimation of student knowledge and interest in human trafficking. Thirdly, the questionnaire used to survey medical students was created de novo and not validated, and may not have accurately measured students’ awareness and attitudes.
Additionally, the fact that the survey focused on the issue of human trafficking could have biased students towards responding favorably towards questions about their interest in learning about this topic. Finally, the goal of this study was to provide evidence for the need for curriculum development, but development or evaluation of specific teaching resources was beyond the scope of the study.ConclusionsThis study provides an assessment of early medical students’ awareness of human trafficking at one medical school. Our study is the first, to our knowledge, to provide some direct evidence to justify and guide the implementation of human trafficking, a critical social justice issue, into the medical curriculum. Beyond cultural competence: critical consciousness, social justice, and multicultural education. Migration, sexual exploitation, and women's health: A case report from a community health center. HIV prevalence and predictors among rescued sex-trafficked women and girls in Mumbai, India.
The health of trafficked women: a survey of women entering posttrafficking services in Europe.
Sex-trafficking, violence, negotiating skill, and HIV infection in brothel-based sex workers of eastern India, adjoining Nepal, Bhutan, and Bangladesh.
Syphilis and hepatitis B Co-infection among HIV-infected, sex-trafficked women and girls, Nepal. Assessment of emergency department provider knowledge about human trafficking victims in the ED. Developing a novel Poverty in Healthcare curriculum for medical students at the University of Michigan Medical School.



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