CHIP: Facilitating Interprofessional and Culturally Competent Patient Care Through Experiential Learning in China

International short-term placements in health professions education-A meta-narrative review

INTRODUCTION

In order to be prepared for professional practice in a globalised world, health professions students need to be equipped with a new set of knowledge, skills and attitudes. Experiential learning gained during an international placement has been considered as a powerful strategy for facilitating the acquisition of global health competencies. The aim of this review was to synthesise the diverse body of empirical research examining the process and outcomes of international short-term placements in health professions education.

METHODS

A systematic review was conducted using a meta-narrative methodology. Six electronic databases were searched between September 2016 and June 2022: Medline, Embase, CINAHL, PsycINFO, Education Research Complete and Web of Knowledge. Studies were included if they reported on international placements undertaken by undergraduate health professions students in socio-economically contrasting settings. Included studies were first considered within their research tradition before comparing and contrasting findings between different research traditions.

RESULTS

This review included 243 papers from 12 research traditions, which were distinguished by health profession and paradigmatic approach. Empirical findings were considered in four broad themes: learner, educational intervention, institutional context and wider context. Most studies provided evidence on the learner, with findings indicating a positive impact of international placements on personal and professional development. The development of cultural competency has been more focus in research in nursing and allied health than in medicine. Whereas earlier research has focussed on the experience and outcomes for the learner, more recent studies have become more concerned with relationships between various stakeholder groups. Only few studies have looked at strategies to enhance the educational process.

CONCLUSION

The consideration of empirical work from different perspectives provides novel understandings of what research has achieved and what needs further investigation. Future studies should pay more attention to the complex nature of the educational process in international placements.

Strategies for Incorporating Health Disparities and Cultural Competency Training into the Pharmacy Curriculum and Co-curriculum

Objective. To identify and review strategies reported in the literature for strengthening instruction about both health disparities and cultural competency (HDCC) within various portions of the Doctor of Pharmacy curriculum and co-curriculum.Findings. The classroom strategies reported in the literature for incorporating HDCC into the PharmD curriculum involved teaching a single course or series of courses in HDCC. Activities found to be effective in teaching HDCC were those that involved case-based and community engagement exercises. Recommendations for incorporating HDCC into the experiential education included preceptor development in areas of HDCC to assess student understanding of health disparities concepts, increasing student engagement with diverse patient populations, and implementation of cross-cultural communication models at clinical sites. Co-curricular and interprofessional (IPE) portions of pharmacy training were found to permit greater methodological flexibility for incorporating training in HDCC, as they often confronted fewer time or space constraints than classroom endeavors. Documented methods for teaching HDCC within co-curricular and IPE experiences included service learning, study abroad, symposia, and forums.Summary. There is a paucity of literature describing processes for incorporation of health disparities and cultural competency education and training into the PharmD program. Findings suggest that conceptual frameworks for HDCC should be used throughout the pharmacy curriculum, with learning activities mapped to relevant pharmacy education standards to ensure coverage of important practice competencies. Best practices also involve the use of contemporary tools, strategies, and resources from a cross-section of disciplines that provide opportunities for learners to correct misconceptions and biases through active situational problem-solving.

A Systematic Review of Assessment Tools Measuring Cultural Competence Outcomes Relevant to Pharmacy Education

Objective. To identify and describe validated assessment tools that measure cultural competence and are relevant to pharmacy education.Methods. A systematic approach was used to identify quantitative cultural competence assessment tools relevant to pharmacy education. A systematic search of the literature was conducted using the OVID and EBSCO databases and a manual search of journals deemed likely to include tools relevant to pharmacy education. To be eligible for the review, the tools had to be developed using a study sample from the United States, have at least one peer-reviewed validated publication, be applicable to the pharmacy profession, and be published since 2010.Results. The systematic literature and manual search identified 27 tools. Twelve assessment tools met the criteria to be included in the summary and their relevancy to pharmacy education is discussed.Conclusion. A review of literature demonstrates that assessment tools vary widely and there is no one tool that can effectively assess all aspects of cultural competence in pharmacy students or the Doctor of Pharmacy curriculum. As cultural competence is a priority within the accreditation standards for pharmacy education, PharmD programs are encouraged to develop additional tools that measure observed performance.

The impact of cultural immersion international learning experiences on cultural competence of nursing students: A critical integrative review

BACKGROUND

Cultural immersion international learning experiences (CIILEs) are commonly offered in undergraduate nursing education programs worldwide, often with the goal to enhance students' cultural competence.

PURPOSE

The purpose of this integrative review was to explore the most recent existing literature concerning the impact of CIILEs on nursing students' cultural competence and to cast a critical eye on the findings.

METHOD

We searched the CINAHL database for articles published from 2015 to 2019 and found 30 that met inclusion criteria.

RESULTS

The majority of the studies were descriptive or qualitative designs and reported positive overall student cultural competence outcomes.

CONCLUSION

The findings support the use of CIILEs with a critical eye for potential negative consequences. The authors recommend further longitudinal, observational studies to identify factors that facilitate substantial long-term positive outcomes.

Current Landscape of Teaching Diversity in Occupational Therapy Education: A Scoping Review

IMPORTANCE

Critical research in health professions education makes clear the role of educational institutions in perpetuating problematic discourses related to diversity, as well as their potential role in dismantling and rebuilding those discourses to reflect the realities of power relations that create systemic injustice.

OBJECTIVE

To provide a comprehensive overview of current pedagogical practices and educational paradigms used by occupational therapy educators to teach concepts of, and skills for, equity and diversity.

DATA SOURCES

Seven education and health care databases were searched for articles published between 2007 and 2018.

STUDY SELECTION AND DATA COLLECTION

Consensually developed criteria were refined until an agreement rate of >80% was achieved among the authors. Inclusion criteria focused on entry-level occupational therapy education across the world and explicitly examined approaches to teaching diversity. All articles meeting the criteria were kept for full-text review (N = 87).

FINDINGS

Diversity in professional occupational therapy education programs is taught within five main underlying educational paradigms and theories: competency-based (44%), social justice (29%), critical (11%), social accountability (10%), and constructivism (6%). Within these paradigms, 14 key pedagogical practices were applied, with community service learning (37%), international service learning (25%), and didactic or course-based practices (23%) making up the majority of pedagogical practices.

CONCLUSIONS AND RELEVANCE

Although current occupational therapy research demonstrates a trend toward critical paradigms and practices, problematic cultural competency theories and uncritical international service learning practices continue to dominate occupational therapy education for diversity. Educators should implement pedagogies and approaches within critical educational paradigms.

WHAT THIS ARTICLE ADDS

This article highlights the importance to occupational therapy education of attending to coherence across educational ethics, paradigms, and learning outcomes in teaching for diversity and health equity.

Experiences within a cross-cultural academic exchange programme and impacts on personal and professional development

Introduction

As society becomes increasingly internationalised, it is important to consider international perspectives on occupational therapy education. There is little research on the experiences and impacts of international learning opportunities such as through academic exchange programmes. The aim of this study was to explore the impacts of an international academic exchange programme among occupational therapy students.

Methods

This study was conducted as a qualitative research study. Data were collected by in-depth semi-structured interviews with nine participants (three men and six women) who participated in an exchange programme at Thomas Jefferson University in the United States and graduated from Kitasato University in Japan. A grounded theory approach was used to analyse the qualitative data.

Findings

Educational outcomes were sorted into four categories: experience, reaction, learning and behaviour. Knowledge and experience gained from the international exchange programme had a positive impact on the personal and professional development of the participants. Participants reported that the programme helped them in acceptance of diversity, collaborating beyond boundaries and gaining confidence from challenges. These impacts persisted even after they graduated.

Conclusions

In an increasingly globalised world, internationalisation of occupational therapy education is significant to build a global community of occupational therapists who seek to improve their practice.

International allied health student placements: A meta-synthesis

BACKGROUND

Increasingly universities are offering international student placements as part of the global internationalisation movement. This review sought to synthesize the findings of studies to further understand the learning outcomes described by allied health students.

AIMS/OBJECTIVES

To contribute to the understanding of the learning outcomes described by allied health students who have undertaken an international placement.

METHODS

A qualitative meta-synthesis was conducted. From six databases, twenty-one studies were identified and critically appraised. Data were meta-aggregated, integrated and interpreted to develop new themes, with the experiences of over 259 allied health students synthesized.

RESULTS

Themes include: the intertwined personal and professional development experienced by the students; confidence and independence, relationship building, insight into culture, service provision and differences in socio-economic and political contexts.

CONCLUSION

Universities offering students international placements provide their students with opportunities to achieve unique learning outcomes with significant personal and professional transformational development that cannot be replicated by local placements.

Evaluating Cultural Competence in an Occupational Therapy Pediatric Course

This study examined the impact on student cultural competence of using specific guided activities in a pediatric occupational therapy course. A combined two-group pre-posttest design was used with a convenience sample of 41 entry-level occupational therapy doctoral students. Using a measure of cultural competence change, results indicated significant increase in scores from pre to post course testing suggesting cultural competence structured activities in course work were associated with an increase in student cultural competence. Implications for occupational therapy education are discussed.

Using Guided Reflection to Link Cultural and Service Learning in a Study Abroad Course

The literature indicates that service learning integrated into a study abroad course results in cultural learning, personal growth, and professional development. However, there are inadequate examples of strategies to achieve cultural learning in the context of study abroad. The purpose of this article is to briefly describe the authors' collaboration with leaders of an international health system in developing a faculty-led study abroad course and describe strategies to promote guided reflection to achieve cultural learning. The preparation phase of the course was delivered with two video conferences and an online learning management system for students on three campuses. Service learning with clinic nursing staff of the international health system and children in a residential home was purposefully incorporated in the study abroad phase of the course. During the first week of study abroad, specific prompts for daily journaling were introduced to the students to promote guided reflection as a critical component of service learning. During the second week, students discussed concepts that had been introduced during the preparation phase. The students wrote a final summary reflection paper with the guidance of additional prompts and an evaluation rubric. In summary, preparation phase learning activities, study abroad phase daily journaling and group discussion combined with a summary reflection paper were used as strategies to achieve cultural learning.