Minority international research training program: global collaboration in nursing research

Formación bioética e intercultural en enfermería: revisión temática

Objetivo: analizar las tendencias de la formación bioética e intercultural en los programas de enfermería, y establecer los aspectos que deben contemplarse para mejorar la formación. Materiales y método: búsqueda de información en bases de datos científicas de acceso libre y repositorios de tesis doctorales de universidades; se utilizaron las palabras clave: “Bioética”, “Educación”, “Formación”, “Enfermería”, “Cultura”, en español e inglés. No se establecen límites según la fecha de publicación. Resultados: la mayoría de investigaciones se enfocan en el currículo académico, hay poca información sobre interculturalidad, pero se retoma el tema de transculturalidad. Conclusión: es necesario hacer de la ética y la bioética un tema trasversal en los currículos académicos, además de incluir la interculturalidad en los planes de estudio.

Perceived reciprocal value of health professionals' participation in global child health-related work

Background

Leading children’s hospitals in high-income settings have become heavily engaged in international child health research and educational activities. These programs aim to provide benefit to the institutions, children and families in the overseas locations where they are implemented. Few studies have measured the actual reciprocal value of this work for the home institutions and for individual staff who participate in these overseas activities. Our objective was to estimate the perceived reciprocal value of health professionals’ participation in global child health-related work. Benefits were measured in the form of skills, knowledge and attitude strengthening as estimated by an adapted Global Health Competency Model.

Methods

A survey questionnaire was developed following a comprehensive review of literature and key competency models. It was distributed to all health professionals at the Hospital for Sick Children with prior international work experience (n = 478).

Results

One hundred fifty six health professionals completed the survey (34%). A score of 0 represented negligible value gained and a score of 100 indicated significant capacity improvement. The mean respondent improvement score was 57 (95% CI 53–62) suggesting improved overall competency resulting from their international experiences. Mean scores were >50% in 8 of 10 domains. Overall scores suggest that international work brought value to the hospital and over half responded that their international experience would influence their decision to stay on at the hospital.

Conclusions

The findings offer tangible examples of how global child health work conducted outside of one’s home institution impacts staff and health systems locally.

Electronic supplementary material

The online version of this article (doi:10.1186/s12992-017-0250-8) contains supplementary material, which is available to authorized users.

Impact of Global Health Research Training on Scholarly Productivity: The Fogarty International Clinical Research Scholars and Fellows Program

In the Fogarty International Clinical Research Scholars and Fellows (FICRS-F) Program, 536 U.S. and international doctoral and postdoctoral health profession students and trainees completed 1-year research training at research centers in low- and middle-income countries. To evaluate the Program's impact, we analyzed data gathered prospectively during the Program, from PubMed, and from a representative survey of alumni. Of 100 randomly selected respondents, 94 returned the survey. Reflecting the sources of funding, human immunodeficiency virus/acquired immunodeficiency syndrome was the focus of 47% of the projects, but research in noncommunicable diseases (NCDs) and dual infection/NCD-related topics increased over time. Among the first 1,617 alumni publications, output was associated positively with being an international versus U.S. trainee, a postdoctoral Fellow versus predoctoral Scholar, and accumulation of more years post-training (all P < 0.001). Fellows were first author on a higher proportion of their articles than were Scholars (P < 0.001), and U.S. trainees were more often first author than international trainees (P = 0.04). Survey respondents had submitted 117 grant applications, and 79 (67.5%) had been funded. The FICRS-F Program yielded substantial research productivity in the early post-training years. Research outputs and impact will increase over time as alumni careers mature and they gain research independence and assume leadership positions.

Impact of Global Health Research Training on Career Trajectories: The Fogarty International Clinical Research Scholars and Fellows Program

From 2004 to 2012, the Fogarty International Clinical Research Scholars/Fellows Program (FICRS-F) provided 1-year research training opportunities for U.S. and international doctoral "Scholars" and postdoctoral "Fellows" at low- and middle-income country (LMIC) centers. We collected data prospectively and then surveyed a representative sample of 100 alumni (94% response), assessing Program impacts on their careers and collaborations. Frequently, collaborations continued beyond the formal training period with U.S.- (63%) and site-based mentors (66%). U.S. Fellows reported the highest post-training focus on research (88 on a 100-point scale), and the highest Program impact on competitiveness for career or training positions and choices of post-training topics and institutions (95 points). Interest in global health research increased markedly during the training period, especially for LMIC trainees, and was sustained post-training. LMIC alumni reported a significantly higher focus on global health and research than did U.S. alumni. Alumni reported that their mentored research training had a substantial impact on their career trajectories.

Recruiting trainees for a global health research workforce: the National Institutes of Health Fogarty International Clinical Research Scholars Program selection process

Between 2004 and 2012, the National Institutes of Health Fogarty International Clinical Research Scholars (FICRS) Program provided 1-year mentored research training at low- and middle-income country sites for American and international health science doctoral students. We describe the centralized application process, US applicant characteristics, and predictors of selection/enrollment. FICRS received 1,084 applicants representing many health professions and biomedical disciplines at 132 US academic institutions; 219 students from 72 institutions were accepted and enrolled. Medical/osteopathic students comprised 88.9% of applicants and 85.8% of enrollees. Applicants from institutions with higher applicant numbers were two times as likely to be selected. In 2012, FICRS was decentralized among 20 institutions in five consortia (Global Health Fellows), with autonomous selection processes that emphasize post-doctoral trainees. If academia, government, or charitable foundations offer future opportunities to health professions students for international research, the FICRS experience predicts that they can attract substantial numbers of motivated trainees from diverse backgrounds.

Immersion research education: students as catalysts in international collaboration research

BACKGROUND

This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research.

AIM

To narrow the healthcare gap for disadvantaged families in the USA and partner countries.

METHODS

Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the MHIRT program complete two introductory courses followed by a 3-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored.

RESULTS

Cross-fertilization of research, cultural awareness and ideas about improving family health occur through education, international exchange and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences and healthcare systems. The students are catalysts in the research effort, the dissemination of research findings and other educational endeavours. Five steps of the collaborative activities lead to programmatic success.

CONCLUSIONS

MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations.

Nurturing the global workforce in clinical research: the National Institutes of Health Fogarty International Clinical Scholars and Fellows Program

The Fogarty International Clinical Research Scholars and Fellows Program's goal is to foster the next generation of clinical investigators and to help build international health research partnerships between American and international investigators and institutions. Through June 2012, 61 sites in 27 countries have hosted 436 Scholars (American students or junior trainees from the host countries) and/or 122 Fellows (American and host country postdoctoral fellows) for year-long experiences in global health research. Initially, the program was oriented toward infectious diseases, but recently emphasis on chronic disease research has increased. At least 521 manuscripts have been published, many in high-impact journals. Projects have included clinical trials, observational studies, translational research, clinical-laboratory interface initiatives, and behavioral research. Strengths of the program include training opportunities for American and developing country scientists in well-established international clinical research settings, and mentorship from experienced global health experts.

Studying abroad: a multiple case study of nursing students' international experiences

This paper examines the experiences of nursing students undertaking an international placement during their pre-registration education. The study took place in two schools--one in the United Kingdom, and one in Sweden. The move of nursing education into higher education enabled students to participate in international exchange programmes. Previous research demonstrates that students participating in such programmes may gain enhanced cultural awareness and experience personal and professional growth. The study comprised a multiple case study, utilising semi-structured individual and group interviews and documentary analysis. Eighteen students from the UK and 14 from Sweden participated. Participants described an increase in confidence, self-reliance and professional knowledge and skills resulting from their international placement. There was an awareness of how healthcare roles differ between countries and a change in attitudes to others from different backgrounds and cultures. The differences between the two cases were marginal. Whilst there was support from both home and host universities this varied between the international placement providers. The international placements were beneficial; however, there is a need for change in the preparation, support and monitoring of students, greater engagement with the partner institutions, and more effective mentoring of staff.

The impact of international placements on nurses' personal and professional lives: literature review

AIM

This paper presents a critical review of research literature on the impact of international placements on the lives and practice of nurses.

BACKGROUND

Health care institutions are progressively more aware of the need to respond to diverse patient populations and cultivate leaders to enrich the nursing profession, both locally and globally. One response has been to establish international exchange programmes for nursing students to give them experience of different cultures and health care systems.

METHODS

A search of the literature from 1980 to 2003 using electronic databases was undertaken using the databases CINAHL, ERIC, British Nursing Index, Web of Science, the BIDS Social Science Citation Index and Medline. The keywords used were 'international exchange experience', 'international studies', 'international education', 'international placement(s)', 'exchange programme(s)', combined with 'nurses/nursing', combined with 'evaluation', 'practice', 'education' and/or 'policy'. The papers retrieved used both qualitative and quantitative approaches and were scrutinized for recurring themes.

FINDINGS

Nurses reported significant changes in their personal development, perspectives on nursing practice and critical appraisal of health care systems. They also indicated an increased appreciation and sensitivity towards cultural issues and cross-cultural care. Moreover, differences in placement programmes, such as duration, preparation and debriefing were found to have affected the reported overall international placement experience. However, the primary effects of international placements were identified as personal development and transcultural adaptation.

CONCLUSION

Students should be exposed to a variety of nursing experiences within the host country. This would give them a broad spectrum for comparisons between cultures, nursing practice and health care delivery in those cultures. Therefore, educational institutions are strongly encouraged to provide opportunities for students to participate in nursing care and education in another country.

International community health networking project: two year follow-up of graduates

AIM

This paper presents the perceptions of graduates 2 years post-exchange in a USA-European Union funded programme. The primary goal of this 8-week exchange programme was to increase cultural knowledge and sensitivity by teaching a common module of community health assessment and planning to multi-national groups of undergraduate students in four countries.

BACKGROUND

Cultural diversity and globalization are among the factors that encourage faculty in nursing to develop programmes of international exchange for students. The challenge is to combine the exchange with the teaching of other courses required by the home institution during the same semester.

METHODS

Twenty-one graduates of participating USA schools responded to an open-ended interview by telephone or email 2 years after graduation. Bennett's continuum (1993) of intercultural sensitivity was used to assess cultural development.

FINDINGS

Graduates overwhelmingly supported international education and described its continued impact personally and professionally. Gains in cultural sensitivity were perceived as the greatest benefit and influence on their practice. The majority of graduates were believed to be in Bennett's ethnorelative categories of acceptance and adaptation. The depth and breadth of previous cultural experiences, specific host and home schools, and previous travel were found to be related to development on the intercultural sensitivity continuum.

DISCUSSION

Most important are the findings from this evaluation that provide insight into the factors enhancing growth of intercultural sensitivity. Previous travel, characteristics of the home and host institutions, and the opportunity and willingness to be a cultural outsider were important influences.

Role of research in reconstructing global healthcare for the 21st century

Nursing as the largest healthcare discipline is central within every healthcare system worldwide. This centrality provides the unique opportunity and the express responsibility for the creation of new knowledge through research in reconstructing global healthcare in the 21st century. International nursing research requires collaboration among culturally diverse team members and data collection with multilingual participants. The critical role of ethical research is exemplified by the diverse cultural norms. Language translation of not only the words but also their meanings is paramount to the relevant application of the study results. Institutions and schools of nursing in developed countries must acknowledge and act on the opportunities available and necessary for global collaboration afforded through the technological resources of the 21st century. Clinical nursing scholars who are the expert care providers must be involved in the conduct and application of research if any reconstruction of global healthcare is to succeed.