Exchange programmes and student mobility: meeting student's expectations or an expensive holiday?

Identification of multicultural learning experiences following an international cross campus medical student exchange programme between the UK and Malaysia: a qualitative study

OBJECTIVES

In an increasingly global society, there is a need to develop culturally competent doctors who can work effectively across diverse populations. International learning opportunities in undergraduate healthcare programmes show various benefits. In medical education, these occur predominantly towards the end of degree programmes as electives, with scant examples of programmes for preclinical students. This study set out to identify the multicultural learning experiences following an early year international medical student exchange programme between the UK and Malaysian campuses of one UK medical school.

SETTING

Two cohorts of international exchange programme for second year medical students in the UK and Malaysia.

DESIGN

Interpretivist qualitative design using semistructured interviews/focus groups with students and faculty.

METHODS

Participants were asked about their learning experiences during and after the exchange. Data were recorded with consent and transcribed verbatim. Thematic analysis was used to analyse the data.

RESULTS

Four themes were identified: (1) overall benefits of the exchange programme, (2) personal growth and development, (3) understanding and observing a different educational environment and (4) experiencing different healthcare systems.

CONCLUSION

The international exchange programme highlighted differences in learning approaches, students from both campuses gained valuable learning experiences which increased their personal growth, confidence, cultural competence, giving them an appreciation of a better work-life balance and effective time management skills. It is often a challenge to prepare healthcare professionals for work in a global multicultural workplace and we would suggest that exchange programmes early on in a medical curriculum would go some way to addressing this challenge.

Erasmus+ Program and Nursing Students' Sense of Coherence, Well-Being, and School Success

BACKGROUND

An international exchange program is an increasing phenomenon across Europe. Any opportunity for students to work or study abroad whilst undertaking their degree program could have a positive impact on their well-being, professional development, and general competences.

METHODS

The study was conducted on a cohort of 99 nursing students from the School of Nursing, who were followed before and after a one-month Erasmus+ mobility period. Quantitative data were collected using a sense of coherence, subjective well-being, and sociodemographic characteristics questionnaire. Qualitative data were collected using open-ended questions and interviewing the focus group.

RESULTS

Student mobility did not significantly alter their sense of coherence or subjective well-being. A significant positive correlation before and after mobility occurred between the sense of coherence, subjective well-being, and school success. According to the qualitative analysis, the students' experiences were overall positive and stimulating, with many of them noticing better working conditions abroad.

CONCLUSION

Although the international mobility of nursing students does not affect their sense of coherence and subjective well-being, it does contribute to changes in certain attitudes related to the profession and living conditions abroad. These findings may prove helpful in planning future mobilities during more favorable periods when school obligations are fewer.

The Impact of ERASMUS Exchanges on the Professional and Personal Development of Medical Students

The ERASMUS program is one of the most popular student exchange projects, particularly among the students of Central and Eastern European countries. However, limited research is available with regard to its influence on the professional and personal development of its participants. The study aimed at investigating the experiences and impact of the ERASMUS program on different domains of the personal and professional life of medical students. A questionnaire containing closed and open-ended questions was distributed among 269 former participants of the ERASMUS program from the Poznan University of Medical Sciences to collect qualitative and quantitative data regarding the topic. The response rate was 41%. Mastering professional foreign language skills was the most frequently reported benefit of ERASMUS (94%), followed by a change of approach towards learning by exposure to innovative teaching techniques, character, professionalism and cultural competency development, impact on the migration decisions of the students, as well as the opportunity to compare healthcare and educational systems across countries. Additionally, 57% of respondents stated that ERASMUS impacted their career plans, and few indicated that it had affected their specialty choice. Approximately 28% of respondents have worked abroad in healthcare or research since graduating. Participation in the ERASMUS program proved to be a unique opportunity for professional and personal development.

Main challenges to international student mobility in the European arena

This study analyses international student mobility (ISM) in Europe since the 1999 Bologna Declaration. International mobility of higher education students is both a driver and a consequence of the Bologna Process and emerges as a relevant issue in a wide range of research areas. This literature review develops a qualitative content analysis of the set of high-performance articles published between 2000 and 2018 and identified through a wide range of bibliometric tools: direct (first generation) citation counts; indirect or accumulated impact; early influence; adjusted impact with respect to year of publication, type of document, and discipline; and alternative metrics that measure interactions in the internet and social media. The content analysis focuses on the pending achievements and main challenges to ISM, among them: attracting non-European students to whole degree programs, the need for actual and further convergence in programs and systems to ensure real compatibility, the impact of HE ISM on the promotion of the European citizenship and consciousness, the sharp imbalance between credit and degree mobility, the need to strengthen the link between ISM and employability, the existing social selectivity in European ISM, the frequent social segregation problems faced by international students.

Preparation of undergraduate health and care students from the United Kingdom for an international learning experience in Japan: A phenomenological study

BACKGROUND

Globalisation, economic migration and people seeking refugee status require cultural competence skills and knowledge to be embedded in undergraduate health and care programmes. International learning experiences can support the development of cultural competence skills. Students require preparation before undertaking international learning experiences to support adjustment to cultural differences. Inadequate preparation could have a negative impact on their ability to learn. Therefore, investigating concerns undergraduate health and care student experience prior to an international learning experience has the potential to enhance the preparation received.

OBJECTIVES

To investigate the experiences of undergraduate health and care students from the United Kingdom prior to participating in an international cultural visit to Japan.

DESIGN

A qualitative study using Interpretative phenomenological analysis.

METHODS

The lived experience of 7 undergraduate health and care students were explored using reflective semi structured surveys.

FINDINGS

The findings suggest that prior to the visit, undergraduate health and care students experienced a range of fears and anxieties. These were themed under the heading of "Barriers to Learning" and further sub themes of "Being a Stranger", "Cultural Differences and "Communication".

CONCLUSION

Preparation for undergraduate health and care students undertaking international learning activities is required to enable them to adapt to the culture they are visiting as well as the culture of the group they are travelling with. Recommendations are made for preparing undergraduate health and students for this.

International clinical placement - Experiences of nursing students' cultural, personal and professional development; a qualitative study

The purpose was to capture the experiences of cultural, personal and professional development during International Clinical Placement (ICP) among nursing students from three European countries. The paper presents findings based on the analysis of 23 reflections written by students immediately after returning from their ICP. The design builds on a qualitative study using a phenomenological approach and meaning condensation inspired by Kirsti Malterud. The analysis revealed four themes: Communication and barriers to be overcome, Culture as a serious business, Personal and professional achievements and Challenges and the importance of preceptorship. The ICP impacted on the participants' personal as well as professional way of understanding themselves as students and future nurses. A profound difference was seen between the achieved learning outcomes of participants completing an ICP in a high- or low-income country, respectively. Language barriers, the local culture and different nursing cultures were often challenging and pushed participants out of their comfort zone. All participants developed their cultural understanding in accordance with the Papadopoulos, Tilki and Taylor Model for Developing Cultural Competence. Findings indicate that educational institutions should establish well-planned exchange opportunities that adopt a two-way reciprocal (Erasmus) exchange programmes and be aware of the value of an appointed preceptor in the host country.

Nursing Lecturers' Perception and Experience of Teaching Cultural Competence: A European Qualitative Study

Cultural competence is an essential component in providing effective and culturally responsive healthcare services, reducing health inequalities, challenging racism in health care and improving patient safety, satisfaction and health outcomes. It is thus reasonable that undergraduate nursing students can develop cultural competency through education and training. The aim of this paper was to investigate nursing lecturers' perception and experience of teaching cultural competence in four undergraduate nursing programs. A phenomenological approach was selected to illicit nursing lecturers' perception of culture and experience of teaching cultural competence. Semi-structured personal interviews were held with a sample of 24 lecturers from four European universities. The anonymized transcripts were analyzed qualitatively following Braun and Clark's phases for thematic analysis. Six themes and fifteen subthemes emerged from thematic analysis of the transcripts. Cultural competence was not explicitly integrated in the nursing curricula. Instead, the lecturers used mainly examples and case studies to illustrate the theory. The integration of cultural content in the modules was unplanned and not based on a specific model. Nursing programs should be examined to establish how cultural content is integrated in the curricula; clear guidelines and standards for a systematic integration of cultural content in the nursing curriculum should be developed.

Learning in liminality. Student experiences of learning during a nursing study abroad journey: A hermeneutic phenomenological research study

BACKGROUND

Study abroad generates positive learning outcomes for students. However, experiences of learning, and processes of learning during unaccompanied-by-faculty nursing study abroad are unclear. This research therefore investigated student nurse experiences of learning during a study abroad journey in order to explore the phenomenon of learning and the processes of learning throughout this journey.

METHODS AND PARTICIPANTS

An interpretivist hermeneutic phenomenological methodology was applied, and twenty student nurses, from the UK and Europe, participated; two individual semi-structured interviews were conducted per participant (post-return and follow-up).

FINDINGS AND CONCLUSIONS

The 'Phenomenological Hermeneutical Method' of data analysis was employed and revealed the phenomenon of learning comprised four themes: 'experiencing a different reality'; 'active sense-making'; 'being with others' and 'being changed and transformed'. When considered together, these themes identify that study abroad was experienced as the liminal space in which learning occurred. Students experienced liminality in this space and the process of learning was triggered by disjuncture. Students took responsibility for learning and undertook active sense-making activities to gain insight. Students struggled to make sense of troublesome experiences, and remained in a stuck place until resolution of troublesome-ness enabled students to cross a threshold into understanding. Learning was also influenced by others. Students experienced change and transformation as a result of the learning that had occurred, and a postliminal state was attained when troublesome-ness was resolved and students had re-integrated into their usual reality. These findings offer insight into student learning during unaccompanied study abroad journeys, and further development of nurse education and research is recommended.

Should I stay or should I go? A systematic review of factors that influence healthcare students' decisions around study abroad programmes

BACKGROUND

Study abroad programmes have been shown to have significant benefits for participating healthcare students such as promoting cultural awareness and understanding of different healthcare settings, policies and practices. Healthcare students are encouraged to undertake elective or Erasmus placements overseas to enhance personal and professional development and to broaden horizons through lived cultural experience. However, there is a relatively low uptake of such opportunities amongst this student group.

OBJECTIVES

This systematic review aimed to explore factors that influence healthcare students' decision making around study abroad opportunities within undergraduate training programmes.

REVIEW DESIGN METHODS

A systematic review was undertaken utilising a narrative synthesis approach.

DATA SOURCES

A comprehensive literature search was conducted on MEDLINE, CINAHL, EMBASE, PsycINFO, ASSIA, and ERIC databases. Key institutions were contacted for grey literature. Studies that reported on factors that influence healthcare students' decisions regarding study abroad programmes were included in the review.

RESULTS

Ten studies were identified for inclusion (5 qualitative studies, 5 surveys), indicating a paucity of research in this area. Data synthesis indicates that factors that influence healthcare students' decisions to participate in study abroad programmes are similar across different geographic locations and different professional groups. Factors that support decisions to study overseas include having sufficient information about study abroad programmes, especially early in an academic programme, having an interest in other cultures/countries and having academic staff and family as positive role models who motivate them to study abroad. Key barriers are cost and language issues. Language remains a significant barrier even when generous bursaries are available, as with the Erasmus scheme, when students are not proficient with the language spoken in host countries. Students tend to prefer destinations where language is not a problem or where countries have cultural or historical connections, such as being part of the Commonwealth countries.

CONCLUSIONS

Promotion of study abroad opportunities needs to start early in an academic programme. It should include detailed information and provision of language support. Faculty have an important part to play as enthusiastic role models.

Beyond Borders: Global Nursing Education for the Future

Most articles on nursing student study abroad experiences are one-sided case studies focusing on students and faculty from developed countries who travel to less developed countries. This article presents the perspectives of students from theUnited States, Chile, Mexico, and Taiwan, both sides of the international exchange experience. Students described the real-world, hands-on experience of immersion in a different health system and professional culture as transformational and having a significant impact on their nursing career goals. In an era of increasing globalization, cross-cultural experiences have great potential for nursing students on both sides of the exchange.

Taking part in Nordic collaboration; nursing students' experiences and perceptions from a learning perspective: A qualitative study

BACKGROUND

Nordic networking of different kinds has a long tradition aiming to increase collaboration and understanding between citizens in different countries. Cultural competence in relation to health care and nursing is important for clinical nurses and is a central issue in nurse education.

OBJECTIVE

To gain an understanding of what nurse students experienced and learned during an intensive course in diabetes together with students and nurse educators from Denmark, Finland, Iceland, Norway, Sweden and the Faroe Islands.

METHODS

In 2012, an intensive course within the Nordic network, Nordkvist, was conducted in Faroe Islands with the theme "Nursing - to live a good life with diabetes". To answer the objective of the study, 26 students conducted written reflections based on two questions. The data was analyzed using qualitative content analysis.

RESULTS

Through meetings with nurse students and educators from the Nordic countries the intensive course strengthened the students' identification with the nursing profession. The students gained new perspectives on diabetes, such as how complex it can be to live with a chronic illness. Because of the difficulties in understanding one another and because of different mother tongues, the students gained a better understanding of patients' vulnerability in relation to hospital jargon and how it felt to be in an unfamiliar place.

CONCLUSIONS

The intensive course increased the students' personal and professional growth, cross-cultural competence, and their identification with nursing. Students' understanding of health care in the Nordic countries improved as similarities and differences were recognized.

Future nurses' cultural competencies: what are their learning experiences during exchange and studies abroad? A systematic literature review

AIM

This article describes the development of cultural competence among nursing students. The focus is on illuminating the learning experiences of nursing students during their exchange.

BACKGROUND

As the world gets smaller, the demand for culturally competent nurses increases. Future nurses need to be open-minded towards international cooperation and willing to develop the quality of care from a cultural point of view. Nursing education in many countries provides an option for students to learn nursing in different cultures while taking part of their studies abroad.

METHODS

A systematic literature search was conducted. Inductive content analysis was applied to the data consisting of empirical studies (n=7) describing nursing students' studies abroad.

RESULTS

The process of developing cultural competence among nursing students on exchange was found to consist of three main themes, namely: (1) an increased cultural knowledge base, (2) personal growth and (3) the impact of exchange experiences on the nursing student's own practice.

CONCLUSIONS

Studies abroad are a beneficial strategy for the development of future nurses' cultural competence.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing is facing a crucial challenge to recruit culturally competent nurses, because an increasing number of patients are from different cultures. Nurses with experiences of studying abroad can offer employers a resource through their preparedness for culturally competent nursing.