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

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.

Addressing Culturally Based Hidden Bias and RacisM (A-CHARM) Using Simulation Experiences, Nik's Story: A Quasi-Experimental Study

BACKGROUND/PURPOSE

Racism and hidden bias experienced by underrepresented nursing students contribute to a loss of confidence and anxiety. The A-CHARM nursing project developed virtual simulation experiences for nursing students to practice how to address racism. 'Nik's Story' virtual simulation was created as part of the A-CHARM project. The purpose of this study was to examine the effectiveness of an education intervention, that included Nik's story, on cultural humility and cultural diversity awareness.

METHOD

This quasi-experimental study included a convenience sample of final year nursing students. After informed consent, participants completed a pre-intervention questionnaire that included the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire to assess baseline knowledge. Students participated in an education intervention that included a lecture, Nik's story virtual simulation experience, a debrief and then completed a post-education/simulation questionnaire that included usability/learner engagement questions and the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire.

RESULTS

Forty-seven students consented and completed the pre/post intervention questionnaire. Participants rated the effectiveness, engagement and usability of the simulation experience highly. There was a significant positive change in cultural humility "context for difference in perspective" subscale (pre-scores = 6.9, SD = 3.3; post-scores = 31.0, SD = 3.8, p < 0.001), and cultural diversity awareness (pre-scores = 95.4, SD = 8.9; post-scores = 103.4, SD = 9.8, p < 0.001).

DISCUSSION

This intervention was effective in improving cultural humility and cultural diversity awareness in nursing students.

CONCLUSION

Simulation experiences regarding racism in the clinical setting provide a strategy for students to learn how to professionally navigate unwanted experiences.

Collaborative online international learning in undergraduate nursing education: from inspiration to impact

OBJECTIVES

Collaborative Online International Learning (COIL) is an innovative teaching pedagogy involving faculty collaboration and student co-learning across global partner schools. Guided by the cross-cultural alignment model, the purpose of this educational research project was to analyze the impact of COIL on the knowledge, skills, and attitudes of nursing students in two global partner schools and to determine if groups of students were impacted differently.

METHODS

Students engaged in synchronous and asynchronous learning sessions using a secure digital platform over several weeks. Data was gathered from students using an optional, anonymous, online, retrospective pre-posttest survey.

RESULTS

COIL enhances student understanding of key global nursing concepts and culturally responsive care. Differences across schools were observed.

CONCLUSIONS

COIL is a feasible and cost-effective way to integrate global education into the curriculum of undergraduate nursing education. Recommendations for future COIL experiences are made.

Embracing diversity: measuring the impact of an international immersion learning experience on nursing students’ cultural beliefs and values

Objectives

An international Nursing Leadership Collaborative covened in Japan to hold a patient safety and quality workshop for nursing students from six countries. The purpose was to measure students’ self reported beliefs reflecting sensitivity and openness to cultural diversity before and after the international experience.

Methods

A pre-post-test design was used and the Beliefs, Events, and Values Inventory was administered to international undergraduate and graduate nursing students.

Results

The group aggregate data analysis indicate that prior to the start of the workshop, the group presented itself as quite introspective and after the workshop the group reported being more sophisticated in making causal explanations about why the world works in the way it does.

Conclusions

Nursing students experienced an expanded awareness of their beliefs and values that reflect a greater degree of intercultural sensitivity for acceptance of inclusivity and diversity after the experience.