# Preparing Italian residents for global medical practice: the role of internationalization in education

## TL;DR

This study explores how combining international faculty with simulation-based learning improves cultural competence in medical residents.

## Contribution

The paper introduces a hybrid educational model combining international faculty mobility and simulation-based learning to enhance intercultural competence in medical training.

## Key findings

- Residents showed high gains in cultural awareness and competency through the hybrid educational model.
- Qualitative feedback highlighted that international faculty and simulations broadened cultural perspectives and fostered social skills.
- The hybrid format enabled experiential learning and mutual exchange, suggesting a need for standardized frameworks to assess intercultural learning.

## Abstract

As medical education becomes increasingly global, there is a need to prepare residents for culturally diverse clinical environments. Key questions remain about how best to define, measure, and demonstrate the achieved benefits of international education initiatives, particularly regarding intercultural competence and global adaptability for healthcare professionals. This study addresses this gap by assessing a hybrid educational model that combines international faculty mobility with simulation-based learning.

We implemented the Paediatric EmergenSIMs Pathway, where visiting U.S. faculty led high-fidelity pediatric emergency simulations and culture-focused lectures, followed by debriefings. A cross-sectional mixed-methods design was used, including post-course surveys, interviews, and a separate faculty survey. Quantitative data were analyzed descriptively; qualitative data underwent thematic analysis.

Thirty-five participants (70% response rate) completed the survey. Residents reported learnings of cultural awareness (M = 4.72, 95% CI [4.66–4.78]) and cultural competency (M = 4.65, 95% CI [4.54–4.75]), with slightly lower but still positive learnings in cultural sensitivity (M = 4.08, 95% CI [3.93–4.23]). Qualitative feedback confirmed that international faculty and simulations broadened cultural perspectives and fostered social skills; faculty noted mutual learning and challenges in sustaining partnerships.

Integrating international faculty and simulation-based education fostered intercultural competence, reflective practice, and professional growth. The hybrid format enabled safe, experiential learning and mutual exchange. These findings highlight the need for standardized frameworks to assess intercultural learning linked to faculty mobility and to inform future global medical curricula.

The online version contains supplementary material available at 10.1186/s41077-025-00394-8.

• Internationalization enriches medical training with global perspectives and cross-cultural skills.

• Hybrid educational models, combining simulation and international faculty exchange, enhance learning and global collaboration.

• Standardized and pragmatic evaluation frameworks are needed to measure transferable outcomes.

The online version contains supplementary material available at 10.1186/s41077-025-00394-8.