Research-Based Recommendations for Implementing International Service-Learning

A Descriptive Analysis of the Experiences of Nursing Students Who Participated in an International Service-Learning Project in Haiti

BACKGROUND

Studies have demonstrated multiple benefits of international service-learning experiences in nursing education. These benefits include personal and professional growth, increased cultural sensitivity, and increased self-efficacy.

PURPOSE

The purpose of this project was to describe the experiences of nursing students engaged in an international service-learning experience in Haiti.

METHOD

A descriptive qualitative outcomes evaluation project was utilized to understand student perceptions of this experience. Nine respondents were interviewed about their experiences that took place as part of a nursing capstone course offered at a private liberal arts university in the Midwest. Interview transcripts were analyzed by the authors for common themes.

RESULTS

The six themes identified included: a desire for an international experience to better understand healthcare in a developing country; culture shock; context of poverty; excitement and a sense of "helping" amidst the chaos; feelings of increased confidence, independence, and competence; and personal and professional growth. Responses indicated students felt more confident in caring for individuals from other cultures as well as in basic nursing skills and interprofessional communication after this experience. Participants' narratives also indicated intent to serve vulnerable populations in the future.

CONCLUSIONS

The nursing students perceived increased sociocultural understanding and self-efficacy following a 10-day international service-learning experience.

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.

Transformative Learning in an International Immersion Experience for Nursing and Other Undergraduates

ABSTRACT

This qualitative study described the experience of undergraduates in an international immersion experience designed to foster health promotion among rural Ghanaians. Data in the form of students' reflective writings were analyzed in a rigorous process of literal, interpretive, and reflective readings. Two themes (character building and feeling inspired by others) emerged from the data. The findings suggest that this immersion trip facilitated the transformation of the participants and the development of their cultural competence.

How much can our universities do in the development of cultural intelligence? A cross-sectional study among health care students

BACKGROUND

Cultural intelligence reflects the competence to adapt to new cultural settings. Universities offer students various opportunities to gain cultural learning and develop cultural intelligence. However, there has been little empirical research to compare the effects of cultural learning and other related psycho-social factors in this process.

OBJECTIVE

This study explores the importance of cultural learning and identifies the unique contribution of cultural education in universities to health care students' cultural intelligence.

DESIGN

Cross-sectional survey study.

METHODS

271 health care students completed a survey measuring social desirability, demographics, personality, prior cultural exposure, previous cultural learning and cultural intelligence.

RESULTS

Hierarchical regressions showed that cultural learning could affect cultural intelligence and its three components (i.e., metacognition, cognition, motivation, and behaviour) under the control for related psycho-social factors. However, its effect on the behavioral component was not significant. Considering the different types of cultural learning, overseas study experiences were more related to cultural intelligence, compared to in-class cultural learning.

CONCLUSION

Cultural learning, especially overseas study experiences, plays a significant role in the development of health care students' cultural intelligence.

Does volunteering change attitudes towards people with disabilities? A qualitative study of the experience of orthodox Jewish nursing students

BACKGROUND

People with disabilities identify negative staff attitudes and behaviors as barriers to accessing health services. Studies show that nursing education activities specific to people with disabilities improves nursing care. This study explores the experience of orthodox Jewish nursing students volunteering with people with disabilities, how their attitudes towards this population changed.

DESIGN

A qualitative design was used. This research is part of an extensive ongoing study of orthodox and ultra-orthodox (Haredi) students volunteering with people with disabilities.

METHODS

Data from 13 semi-structured interviews, conducted between July and September 2017, with 14 male students (two students chose to be interviewed together) and four people with disabilities were analyzed using thematic analysis.

RESULTS

Volunteering enhanced students' awareness of the needs of people with disabilities, changed their attitude towards this population and enhanced their confidence as nurses. The individuals with disabilities valued the help they received as well as the opportunity to change the students' prior notions and stigmas regarding disability.

CONCLUSIONS

Projects such as ours could improve the attitude of nursing staff towards individuals with disabilities and improve nursing care. We recommend involving people with disabilities in designing such projects.

Institutional factors associated with global health education across US pharmacy schools

INTRODUCTION

The objective of this study is to explore the relationship between institutional factors and offerings of global health education opportunities in pharmacy schools.

METHODS

Data for this project came from a review of international advanced pharmacy practice experiences (APPEs) and global course offerings for US pharmacy schools conducted between February 1 and March 31, 2014. These data were merged with data on institutional factors which may influence a school's offering of APPEs or courses. Institutional factors included tuition, class size, academic medical center affiliation, year established, and others. Multivariable regression models were used to evaluate the relationship between individual institutional factors and APPEs and global courses.

RESULTS

In multivariable adjusted models, older and more established schools had a larger percent of the graduating class with an international APPE (9.5% vs. 2.6%, p < 0.01) and a larger number of international APPEs (3.8 vs. 1.4, p < 0.01) than schools founded after 1980. Schools with higher tuition (>$25,000/year) had, on average, a larger percent of their graduating class with an international APPE (7.9% vs. 3.1%, p < 0.05), a larger number of international APPEs (3.7 vs. 1.5, p < 0.01), and more interprofessional international APPEs (3.1 vs. 0.7, p < 0.001). There were more course offerings at older schools (1.1 vs. 0.4, p < 0.05) and those with higher tuition (1.3 vs. 0.4, p < 0.01).

CONCLUSIONS

More established schools and those with higher tuition appeared to have more robust global offerings. Schools can consider local opportunities to provide global experiential and didactic experiences, which may reduce the financial burden of global programs.

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.

Preparing Undergraduates for the Global Future of Health Care

BACKGROUND

Health professionals must be academically and experientially prepared regarding the social determinants of health to reduce health disparities at the global level. The emerging literature reflects a trend for incorporating global health competencies for health care. Specifically, recommendations from the Consortium of Universities for Global Health, National Academy of Medicine, and multiple nursing organizations encourage the inclusion of a global health curriculum.

OBJECTIVES

To describe the development of an undergraduate global health certificate program and provide recommendations for the development of future global health programs.

FINDINGS

At the completion of the certificate program, students felt better prepared to apply course content to culturally diverse populations in low resource settings.

RECOMMENDATIONS

Before developing a global health program, preconceived ideas about study abroad experiences and faculty concerns associated with course overload should be dispelled through evidence-based, educational sessions. Curricular time constraints in content-laden programs should be mitigated through an appropriate mix of e-learning formats. Last, a strong value must be placed on interprofessional education to facilitate capacity building through a bi-directional flow of knowledge and resources between the educational institution and the host country.

Establishment of a short-term global health nursing education experience: impact on students' ways of knowing

BACKGROUND

The Essentials of Baccalaureate Education for Professional Nursing recognizes that with the increased globalization of health care, professional nurses have to be prepared to practice in multicultural environments and must possess the skills needed to provide culturally competent care.

METHOD

Thirty-five baccalaureate nursing students participated in a short-term course abroad to Jamaica over a period of 3 years. The impact of such an experience on ways of knowing was assessed in 20 participants, using a visual analog scale.

RESULTS

Students believed that the short-term course abroad experience had a positive impact on their personal knowing and that they developed an understanding of a health care system different from their own, while reflecting on issues of social justice.

CONCLUSION

Results provide evidence of the positive impact on short-term course abroad trips on students' ways of knowing. Critical to establishment of these experiences is evaluation of their merit through documentation of student learning outcomes.

Lessons learned about ageing and gerontological nursing in South Africa

Background

The unprecedented global growth in older adults merits high-quality gerontological nursing care. As gerontological nursing grows in visibility in developed and developing countries, nurses must possess a broader worldview of ageing with knowledge of physiological, psychosocial, and cultural issues.

Purpose

The purpose of this article is to: (1) highlight lessons learned on differences and similarities in ageing and care of older adults in the United States of America (USA) and South Africa (SA); and (2) provide recommendations on how to advance gerontological nursing education in SA.

Methods

A two-week international service-learning project was undertaken by visiting SA and learning about their nursing system and care of older adults. Service-learning is an innovative teaching-learning-service method that provided reflective and hands-on experience of gerontological nursing. This article provides a personal reflection of lessons learned about ageing and gerontological nursing during the service-learning project.

Findings

Care of older adults in SA is in many ways different from and similar to that in the USA. Consequently global nurses should recognise those differences and provide culturally appropriate care. This service-learning experience also demonstrated the need for gerontological nursing education in SA. Based on this, recommendations on how to infuse and advance gerontological nursing education in SA are provided.

Conclusion

Caring for older adults in a global context requires knowledge and understanding of cultures and their values and practices. With a growing population of diverse older adults, there is a need for incorporation of more gerontological education in nursing curriculums and clinical experiences.