Long-Term Learning in a Short-Term Study Abroad Program: “Are We Really Truly Helping the Community?”

Development and validation of an assessment tool for higher education learning abroad programs: A qualitative Delphi study

BACKGROUND

Higher education learning abroad programs provide many benefits to healthcare students. However, inadequate preparation prior to their international travel, and misdirected motivations for their participation, can jeopardise the benefits and increase the risks. While it is pivotal to objectively evaluate pre-departure student preparation and the impact the programs have on students, existing assessment questionnaires fail to inform these aspects.

OBJECTIVES

To develop an assessment tool (two surveys) to holistically evaluate learning abroad programs for higher education healthcare students.

DESIGN

A qualitative Delphi technique.

PARTICIPANTS

A total of 24 experts who had designed, managed, participated in, hosted, funded, and/or researched Australian learning abroad programs for higher education students.

METHODS

The study was conducted over a 4-month period. An initial set of pre-departure and post-program questions was developed through a review of the existing literature and from a post-program survey previously used at an Australian higher education institution. Subsequently, experts provided constructive and practical feedback on the questions to be included in the two surveys.

RESULTS

The experts reached consensus on the 26 questions to be included in the pre-departure survey and the 16 questions in the post-program survey after three Delphi rounds. Key areas of interest to the experts were mitigating student risk, improving effectiveness of pre-departure briefings, gaining a better insight into student motivations for participation, and understanding the impact the programs have on students.

CONCLUSIONS

The development of this valid assessment tool (two surveys) will provide higher education institutions and program leaders with the ability to better evaluate the effectiveness of the pre-departure preparation they provide to students, understand the motivations of students who participate, as well as assessing the impact these programs have on students. The insights gathered can be used to improve future program offerings and maximise the benefits to healthcare students while reducing the risks.

Registered nurses' experiences and perceptions of supervising international nursing students in a clinical setting - A qualitative study

AIM

The aim of the study was to examine the experiences and perceptions of Indian RNs who supervise Norwegian undergraduate nursing students during their clinical practice in India.

BACKGROUND

The globalization process has generated a need for registered nurses (RNs) to develop cultural competence. As a result, nursing education and policy need to respond to the challenging nature of global health and prepare RNs to work with diverse cultures by enhancing their cultural competence to help them encounter patients from different cultural backgrounds. Yet, the research investigating the experience of supervisors in non-western countries receiving students from western countries is sparse DESIGN: An exploratory descriptive design.

METHODS

Eight individual semi-structured interviews were undertaken by Indian Registered nurses, supervising Norwegian nursing students. Three of the interviews were conducted in their workplace in India, while the rest were carried out using Zoom conference due to the COVID19 pandemic. The interviews were conducted between January - December 2020. Inductive qualitative content analysis was used to analyse the data.

RESULTS

Thematic analysis elicited four main themes: 1) Preparation to receive international students, 2) The role of supervising international students, 3) Learning from the students, 4) Challenges of supervising international students CONCLUSIONS: Participants provided valuable insights into the role of supervising international nursing students in India. This insight is considered important since many students from Western countries go to non-Western countries for international exchanges. The study highlights the fact that the method of supervision is connected to the culture and is different in Western and non-Western countries. Even though they acknowledged several challenges with having international students, supervisors emphasized that having international students was a positive experience and that they learned from them.

Enhancing the Cultural Competence of Baccalaureate Nursing Students Through Short-term Study Abroad Programs

ABSTRACT

The purpose of this study was to examine the experiences of baccalaureate nursing students on a short-term study abroad program to Peru and the effect on baccalaureate nursing student cultural competence. A qualitative descriptive study was conducted using student pretravel and posttravel journals. The major themes of advocacy, ethnocentric shift, and cultural competence emerged after the study abroad program. Results of this study will be used to inform and improve future study abroad programs to prepare students for a career caring for diverse clients.

Reported outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education: A narrative systematic review

OBJECTIVE

To identify outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education.

DESIGN

A systematic review of the literature was conducted in keeping with JBI methods.

DATA SOURCES

A range of databases were searched, including Medline, Embase, ERIC, CINAHL, ProQuest Central and DOAJ. Studies published in English from 2010 to 2020 were considered.

STUDY ELIGIBILITY CRITERIA

The review included qualitative and quantitative primary peer-reviewed research studies involving nursing or midwifery students who participated in international educational programs in their pre-registration education.

REVIEW METHODS

Thematic analysis informed by Braun and Clarke was used to identify key outcomes emerging.

RESULTS

56 studies were included. The results highlight similarities in outcomes for students who had undertaken international educational programs in three thematic areas: Cultural learning, Personal growth, and Professional development. Short-term outcomes are well documented, however there is a lack of research investigating long-term outcomes.

CONCLUSIONS

Further research is required to investigate long-term outcomes of international educational programs and means for measuring the effects on students' future professional practice. In addition, further research is needed to explore the perspectives of, and impact on, others including host communities and universities, and other stakeholders.

Nursing students' experiences of moral uncertainty in the context of global health practicums

More students than ever are electing to take part in international practicums from health-related disciplines. With the goal of better understanding the moral experiences and ethical implications of global health practicums (GHPs), the purpose of this Interpretive Descriptive study was to examine the moral uncertainty of nursing students from one university in Canada. Seventeen nurses who had participated in a GHP in their undergraduate nursing program participated in semi-structured interviews. Data were analyzed inductively using constant comparative data analysis techniques, and a thematic account of participants' experiences was developed. Findings suggest that nursing students experienced considerable amounts of moral uncertainty during their GHP. Most often, participants' experiences of uncertainty stemmed from a misalignment between their expectations and reality, including encountering different approaches to healthcare, being situated in new cultural and clinical care environments, and grappling with how best to stay within one's scope of student professional practice. Participants inconsistently reflected on these experiences, which may present a missed opportunity for professional growth through the development of a heightened social consciousness. Educators can facilitate this process by implementing robust predeparture training for GHPs, clarifying program objectives, and providing clinical debriefing.

Ethical global health in nursing education: An integrative review

AIM

The purpose of this integrative review is to provide a comprehensive review of ethical considerations for host communities and nursing programs in planning, implementing and evaluating global health experiences for nursing students.

BACKGROUND

Global health experiences for nursing students are proliferating rapidly across university settings while at the same time decreasing the average time spent in the host country engaged with local communities. Global health experiences are an area where students can experience ethics as it is applied across varied contexts including resource limited international settings. As nursing education expands its global programming, exploring the ethical implications of designing, implementing and evaluating GHEs becomes pivotal to build respectful, sustainable relationships with global partners and best prepare nursing students for ethical professional practice in an interconnected world.

DESIGN

We conducted an integrative review to examine ethical considerations in development of ethical global health experiences that benefit, rather than harm, host communities and participating nursing student guests.

METHODS

The search included articles published in English language, peer-reviewed journals between 1998 and 2021 that discussed ethics in the context of nursing students traveling internationally for global health experiences. Eighteen articles met criteria for review.

RESULTS

Overall, findings demonstrate relatively little research specific to ethical engagement in global health experiences. The articles in this integrative review discussed a range of ethical attributes including reciprocity or collaboration, respect, sustainability or commitment, justice and openness. Recommendations based on research and non-research articles are provided.

CONCLUSIONS

Ethical comportment in global health experiences requires careful planning, implementation and evaluation to assure an equitable and sustainable partnership between host community, faculty and nursing student guests.

The impact of learning abroad programs in developing countries: A scoping review

OBJECTIVES

An increasing number of higher education healthcare students from developed countries are undertaking short-term learning abroad programs in developing countries. However, sociocultural differences between the students and the communities could lead to unintended, possibly negative consequences for the community. The objective of this review was to explore what is known about the impact of learning abroad programs undertaken by healthcare students on the communities in the developing countries who host them.

DESIGN

The six-step scoping review developed by Arksey and O'Malley (2005) provided a methodological framework for searching the literature and identifying records meeting the inclusion criteria.

DATA SOURCES

A comprehensive range of databases were used to facilitate the literature search (including CINHAHL, EBSCO, ERIC, Google Scholar, MEDLINE, PsycINFO, Scopus and Web of Science).

REVIEW METHODS

A two-stage review process was undertaken. Stage 1 reviewed articles on learning abroad undertaken in developing countries by higher education healthcare students. Stage 2 identified articles that reported the impact on the host community. Articles meeting the stage 2 criteria were further assessed for methodological quality using the Critical Review Form for Qualitative Studies.

RESULTS

The stage 2 review revealed less than one quarter of the included articles (n = 36) reported on the impact of the learning abroad program on the host community and across these eight articles, there was a significant diversity in the methodological rigour and outcomes presented.

CONCLUSIONS

This review identified that most of the published research on learning abroad in developing countries focusses almost exclusively on the impact the programs have on the students, with a paucity of research considering how they impact host communities. Our findings suggest the need to further extend and strengthen the research on the host communities in order to understand the impact higher education healthcare students have on the international communities who host them.

Long-term effects on nursing alumni: Assessing a course in public and global health

The impact of a cultural awareness course among nursing students may affect the particular person for years to come. Cultural awareness can be taught via many methods, often requiring study abroad and/or extreme investment of time, money and effort. There is little research on sustained effects on nursing alumni from such a course. The purpose of this descriptive survey study was to determine the long term outcomes of a cultural awareness course and 2) compare the long term effects between alumni who went abroad and those who chose to complete the course locally. One hundred and twenty-one nursing alumni completed the International Education Survey (IES) (Zorn, 1996) with additional open-ended questions. Quantitative and qualitative results concluded: 1) nursing alumni were influenced long term by a course dedicated to public and global health and 2) all alumni had statistically significant IES scores but alumni who studied abroad had the greatest increase.

Going Domestic: Importing the Study Abroad Experience. The Development of a Multicultural New York City Study Away Program

PROBLEM

Significant off-campus domestic study away experiences have been shown to be a transformative active learning environment for students and achieve similar learning outcomes as study abroad programs.

METHODS

This manuscript describes the conception, development, and pedagogical approach of a faculty-led domestic study away experience in New York City for pre-licensure and post-licensure nursing students as an active learning strategy for developing cultural competence. Students participated in service-learning activities that illuminated the realities and challenges persons from other cultures face as they interact with health care in a culture that is not their own.

FINDINGS

In partnership with New York Cares©, students were immersed in well-established ongoing sustainable community-based projects. These experiences fostered reflective conversations between community members, student participants, and faculty regarding social factors, cultural issues and needs, and global issues and trends.

CONCLUSIONS

Through the New York study away program, students were able to broaden their perspectives about social factors and culture beyond geographic or ethnic boundaries and apply these service experiences to their nursing practice. Study away programs are an excellent strategy for nursing educators to prepare students for care of multicultural populations and for proficiency in cultural competency within the globalization of the United States.