Since 1995, Dr. Little has, on a weekly basis, taught patient presentations to visiting international physicians and students as well as interested others under the auspices of the Department of Global Health and Medicine chaired by Dr. Satoru Izutsu. This is a year-round activity and usually takes place in the conference room on the 8th floor of Hale Pulama Mau, Kuakini Hospital, on Thursdays at five o'clock. All attendees present a patient and are critiqued by Dr. Little and sometimes, for content, by residents. This process usually takes an hour and a half to two hours. Most visitors stay for four weeks and on their final night the class celebrates by going out to dinner.
For 25 years, Dr. Little has worked with the Noguchi foundation of Japan and the doctors and medical students they have sent to the University of Hawaii for a four week externship. Those Noguchi graduates, who have become residents in the University of Hawaii system, represent the largest group attending an annual potluck at the Little's home on the North Shore of Oahu. This event occurs in the spring, usually in May, and all residents, their families and friends are invited. In addition, for the past several years, Dr. Little has taught patient presentations skills to medical students from Tokai University School of Medicine, Kobe University School of Medicine, and Kochi University School of Medicine who study Medical English for a week on Oahu in August. Since 2006, she has consulted with the University of Hawaii Department Of Internal Medicine Residency Program regarding the patient presentations skills of their international applicants. As an associate Professor of the School of Medicine at the University of Hawaii (JABSOM), she works with selected international residents in the Pediatrics Residency Program. Most recently, she has replaced the TOEFL examination as a means of determining the communications skills of each applicant.