Table 3 Summary statements for 2nd delphi iteration to confirm consensus

Necessity of PDT & PRD

PDT should be mandatory for all residents going on IME.

100 %

PDT should be mandatory for all residents doing electives in remote First Nations communities.

100 %

PRD should be mandatory for all residents going on IME.

High

PRD should be mandatory for all residents doing electives in remote First Nations communities.

Mod

PDT and PRD should be mandatory for all residents doing electives within vulnerable populations within Canada.

No

PDT Delivery

Programs are encouraged to evaluate their PDT to ensure residents feel what they are learning is relevant to their experiences.

100 %

Individual preparatory work is appropriate, including personal research on destination and issues pertaining to resident specialty, with potential required readings and online modules.

100 %

Group sessions are ideal, fostering team building and shared learning.

High

Fewer longer sessions are preferable to multiple short sessions to ease delivery and resident access.

High

Some component of PDR must be face to face (not written or online).

Mod

PDT Facilitation

There are benefits to multidisciplinary PDT.

High

GH expertise is the most important characteristic of a PDT facilitator.

Mod

Administrative personnel can appropriately the logistics and travel safety component of PDT.

No

PDT Participants

If a group of learners are going to the same destination, the group can involve participants from different health disciplines (i.e. nursing, physio).

Mod

If a group of learners are going to the same destination, the group can be trained together, even if they are at different levels of training.

No

PDT participants should be at a similar level of training.

No

PRD Delivery

A formal evaluation of the elective should be submitted to the program director and to the GH office (or similar body).

100 %

PRD must be delivered in a safe space where residents are free to discuss difficulties and awkward situations without being judged.

100 %

Group PRD is acceptable and may be beneficial in fostering discussion around shared experiences.

100 %

PRD can consist of a single or iterative sessions.

100 %

Individual PRD should be available to any resident who has experienced difficulty on the elective.

High

Timelines are key with PRD being offered shortly after an elective.

High

PRD Facilitation

Facilitator should have resources available for residents who had difficult experiences.

100 %

Facilitator should have knowledge and experience in GH.

Mod

Facilitator should not be in a position to evaluate the resident.

No

Facilitator should not have a vested interest in the elective in question.

No

PRD Participants

Learners should be offered individual PRD if they perceive this to be helpful.

100 %

Learners who have been to the same destination can receive PRD together.

100 %

Learners who have been to different destinations can receive PRD together if their experiences were similar.

Mod