Accidental paradiplomats? The curious case of Ontario school board budgets and Canadian soft power projection

From the earliest studies of soft power in International Relations, the importance of educational exchanges has been well-established. Studies of international education in the context of Canadian soft power often draw on cases from the higher education sector. This article argues that greater attention should be paid to the K-12 level, especially as budgetary pressures in Ontario's education system are leading school boards to rapidly expand their international student recruitment efforts. Although this is not an example of intentional soft power projection, it nevertheless represents an important reminder that subnational actors may accidentally become paradiplomats whose actions have consequences on the international level. Further, this case reveals the importance of paying attention to actors typically overlooked by IR scholarship. Drawing on Joseph Nye's theory of soft power and in conversation with prior research on international education as a mechanism of soft power projection, this article traces the thread between budgetary pressures in Ontario school boards and the broader context of soft power projection.

Review of studies applying Bronfenbrenner's bioecological theory in international and intercultural education research

The Russian-born American psychologist Bronfenbrenner's bioecological perspective on human development is an ideal framework for understanding how individuals negotiate the dynamic environment and their own identities in international and intercultural education settings. However, a review of the current literature shows that most studies either adopted the earlier version of the theory (i.e., the ecological systems theory) or inadequately presented the most recent developments of the bioecological model (i.e., the process-person-context-time model). The construct of proximal processes-the primary mechanisms producing human development according to Bronfenbrenner-has seldom been explored in depth, which means the true value of bioecological theory is largely underrepresented in international and intercultural education research. This article first presents a review of studies that adopt Bronfenbrenner's theory and then offers future directions for the scope and design of international and intercultural education research.

Unraveling the "Greener Pastures" Concept: The Phenomenology of Internationally Educated Occupational Therapists

The Philippines is one of the major labor exporters for health care workers in the world and occupational therapists are the second most likely professionals behind nurses to work in "greener pastures" overseas. This phenomenological study describes the migration experiences of Philippine-trained occupational therapists working in high-income, Anglophone countries. Researchers conducted online interview for 15 participants who were previously/currently unemployed/underemployed. Following an inductive approach to qualitative data analysis, themes were drawn from the migrant therapists' lived experiences. Four themes describe the migration experiences of Filipino occupational therapists: (a) realities of being an occupational therapist in the Philippines, (b) contradictions faced by Filipino occupational therapists upon migration, (c) when the pastures overseas are not greener, and (d) when the pastures overseas are indeed greener. The study contributes to the labor migration discourse in occupational therapy and the critical examination of the idea of "greener pastures."

Starting university during the pandemic: First-year international students' complex transitions under online and hybrid-learning conditions

International education activities suddenly halted due to the COVID-19 pandemic, severely disrupting student mobility and academic learning. Many educational institutions have delivered programs to students through digital devices globally rather than in situ. Such a shift presents a unique opportunity to assess the impact of online and hybrid education for international students. This qualitative study interviewed 30 international students who had arrived on campus and shared their first-year university transition experiences during the pandemic. The analysis shows that spatial and temporal circumstances created two scenarios and thus resulted in different first-year university experiences. Although all students were dissatisfied with online learning, studying at a distance in different time zones was particularly detrimental to international students' mental and physical health. The (im)mobile environments led to mismatches in expectations, roles, activities, and realities, negatively affecting student learning and adjustment. This study highlights the complex international transition issues and offers implications for sustainable online and hybrid-learning practices in the educational system.

The administrative burden on physicians and technicians for organizing international telemedicine conferences: utility of a shared program management system in an international telemedicine network

Background

The use of international telemedicine conferences for doctor-to-doctor education has increased following the coronavirus disease 2019 pandemic to ensure health and safety. Previous studies have shown that administrative tasks are an obstacle to promoting international telemedicine conferences but have not identified the type of system needed to alleviate this burden.

Objective

The Asia-Pacific Advanced Network Medical Working Group (APAN-MWG) is an international telemedicine network that includes 1171 medical institutions and 3653 members as of July 21, 2021. The APAN-MWG has supported international telemedicine conferences since 2005 and implemented a program management system in 2014. The present study explores the conference organizers' tasks and evaluates the APAN-MWG management system through a survey of organizers.

Methods

We developed a system called med-hok for managing conference programs, international medical institutions, and their members. We investigated all event programs using the med-hok system from June 3, 2015 to July 21, 2021. The target samples included 64 conference programs in 12 series hosted by 13 program organizers. The effectiveness of the system was evaluated using a four-point Likert scale (very good, good, poor, and very poor). The User Experience Questionnaire (UEQ) was used to assess user experience.

Results

The survey response rate of the program organizers, who hosted 11 different program series in 7 Asian countries, was 92% (12/13). The administrative tasks for managing the programs were primarily handled by physicians (67%, 8/12), followed by technicians (17%, 2/12). The average program scope encompassed 7 countries, 10 institutions, and 44 members. The largest program comprised 194 members from 49 institutions in 25 countries and was managed by two physicians and one technician. Most program organizers (8/12, 67%) indicated that verifying member information was the most burdensome aspect of organizing teleconferences. Over 90% of respondents positively evaluated med-hok in the following areas: “Confirmation of institution information,” “Confirmation of member information,” “Confirmation of technical information,” “Maintaining the latest status of the program,” “Announcing and publicizing the event,” and “Formatting and correcting misspellings.” They rated user experience positively for all aspects (attractiveness: 1.22; practical quality: 1.42; and hedonic quality: 1.24).

Conclusions

Many tasks of organizing casual international telemedicine conferences are handled by physicians and technicians with no operating funds or staff, unlike those in large academic conferences. The proposed system was found to help program organizers manage participants and communicate information effectively. These findings suggest that international telemedicine networks should implement an administrative support system to conduct program operations efficiently.

A comparison of attitudes toward remote learning during the COVID-19 pandemic between students attending a Chinese and an Australian campus

The COVID-19 pandemic has been a strong driver for moving more teaching and learning activities online. Border restrictions have had a severe impact on international students either hoping to enroll in courses offered in Australia or continue with such courses if they are already enrolled. The online learning experience is likely different between students onshore and offshore. This study took a unique opportunity to investigate any such differences in students' attitudes toward remote learning, necessitated by the pandemic, by comparing two cohorts of students, Australia versus China based. An anonymous survey using the Likert Scale and open-ended questions was available for student feedback on subject delivery. The students based in Australia expressed a preference for remote learning due to the convenience of attendance and availability of the video recordings. However, students in China had a strong preference for face-to-face sessions, with the lack of prior experience in an English-speaking learning environment and hesitance to speak with the lecturers and engage in the learning activities possible reasons for this. In quizzes, students in Australia performed better than those in China regardless of local or international student status. This difference may be due to the Australian-based students' prior experience of English-speaking environments and open-book quizzes. In conclusion, remote learning in a familiar language and learning environment is accepted by students, whereas if the teaching is delivered in a second language using unfamiliar teaching methods, remote learning will require additional scaffolding to enhance their learning experience.

International Virtual Simulation Education in Critical Care During COVID-19 Pandemic: Preliminary Description of the Virtual Checklist for Early Recognition and Treatment of Acute Illness and iNjury Program

SUMMARY STATEMENT

The Checklist for Early Recognition and Treatment of Acute Illness and iNjury program is a well-established, interactive, and simulation-based program designed to improve the quality of care delivered in intensive care units. The COVID-19 pandemic created an overwhelming surge of critically ill patients worldwide, and infection control concerns limited healthcare providers' access to in-person and hands-on simulation training when they needed it the most. Virtual simulation offers an alternative to in-person training but is often complex and expensive. We describe our successful development and initial implementation of an inexpensive, simulation-based virtual Checklist for Early Recognition and Treatment of Acute Illness and iNjury program to address the pressing need for effective critical care training in various resource-limited settings both within and outside of the United States. The overall satisfaction rate ("excellent" or "very good" responses) was 94.4% after the virtual simulation workshop. Our initial experience suggests that virtual interactions can be engaging and build strong relationships, like in-person continuing professional education, even using relatively simple technology. This knowledge-to-practice improvement platform can be readily adapted to other disciplines beyond critical care medicine.

Addressing the challenges of college health in international education

Globalization has become a major force in higher education. Yet, far too little attention has been paid to the effects of the globalization of higher education, whether positive or adverse, on student health. We examine the applicability of the perspectives on the benefits and challenges of globalized healthcare to university student health. Specifically, we question: (1) Do the international healthcare resources adequately meet the needs of adolescents who are living and studying outside their home country? (2) Is a Western framework of medicine being imposed on non-Western cultures? (3) Can student health regulations, best practices, and policies be implemented at an international level? We conclude each section with modest proposals. Our hope is that this article will start the conversation that will expand the research and broaden the perspectives on the globalization of higher education for the benefit of students and the universities and healthcare providers that serve them.

Addressing Foodborne Illness in Côte d'Ivoire: Connecting the Classroom to the Community through a Nonmajors Course-Based Undergraduate Research Experience

The integration of course-based undergraduate research experiences (CUREs) into science, technology, engineering, and mathematics (STEM) laboratory curricula has provided new avenues to engage students at all levels in discovery-based learning. Empirical research demonstrates that CUREs have the potential to foster students' development of scientific process and reasoning skills, attitudes, motivations, and persistence in STEM. Yet, these outcomes are largely reported for studies conducted in the United States, Canada, Europe, and Australia. It therefore remains unclear to what extent CUREs are impactful for students enrolled in alternate international university contexts. To address this concern, we conducted a quasi-experimental mixed methods study to investigate the impact of a one-semester food microbiology and public health (FMPH) CURE on nonmajors students' development of science identity, science communication and process skills, science community values, and science-society perceptions at a private institution in Côte d'Ivoire, West Africa. Content analysis of students' end-of-semester research poster products and thematic analysis of student responses to post-semester open-ended survey items revealed positive gains with respect to student learning and student perceptions of the relevancy of their research to diverse audiences. Paired t-test analyses of pre-/post-semester closed-ended survey responses likewise indicated significant gains in students' science identity and science community values development as well as their confidence in handling and treating foods to reduce the bacterial load on those foods. Collectively, these findings suggest that the FMPH CURE was a meaningful and relevant learning experience capable of promoting students' growth as scientists and scientifically-minded citizens.

Rewarding journeys: exploring medical students' learning experiences in international electives

International electives are recognized as a high-impact practice in clinical education. However, medical students' actual learning experiences during electives have not been explored fully. Specifically, drawing on language management theory, this exploratory case study investigates students' perceived learning outcomes and the managing processes by which they gained benefits from cross-cultural learning experiences in international electives. Written reflective reports in a series of e-portfolios were collected from 43 Japanese medical students who participated in a four-week international elective. Moreover, to further explore their emotions and the reasons behind adopting a particular adjustment behaviour, follow-up interviews with 12 students were undertaken soon after they returned home. Using reflexive thematic analysis, the qualitative data were analysed. Their perceived learning outcomes were categorized into seven themes: medical knowledge and skills, communication, career management and development, international healthcare, society and culture, medical education, and personal development. During the programme, they experienced linguistic, sociolinguistic, and sociocultural difficulties, and attempted to overcome them by employing various adjustment strategies, such as meaning-focused coping, social relationship building, management of learning opportunities, communication management, and developing approaches to learning. Managing problems in academic contact situations is not a linear process; it is iterative and cyclical. Since the combination of several strategies was needed depending on the situation, the management process is a context-dependent and complex phenomenon. The findings in this study provide new insights into student participation in short-term international elective programmes in order to develop academic and social support strategies for educators at both home and host institutions.

Investigating the educational experiences of transnational students: Differences in academic integration, social integration, and institutional and goal commitment

BACKGROUND

Despite the growing popularity of transnational education, there is a dearth of quantitative research regarding how transnational students experience higher education.

AIMS

This comparative study sought to explore differences in educational experiences between transnational and onshore domestic students enrolled either at the Australian (domestic) or Singapore (transnational) campus of an Australian university.

SAMPLE AND METHODS

An online survey gathered responses from 199 domestic students and 313 transnational students.

RESULTS

Results indicated transnational students to be significantly lower than domestic students on social and academic integration, institutional commitment, and satisfaction. No group differences were found in persistence intentions. A series of regression analyses showed integration and commitment significantly predicted student persistence intentions, across both cohorts, beyond demographic and course characteristics.

CONCLUSIONS

This study offers several recommendations for how universities can better foster integration and commitment in their transnational students, including better funding the development of student societies and providing realistic course previews and career advice to students upon entry into their courses. Further, universities are encouraged to reconsider their transnational staffing models to provide more opportunities for academic support and student consultation beyond the classroom.

College student mortality on U.S. campuses compared with rates while abroad

Education abroad can be perceived as riskier for student health/safety than domestic study, but little data exists to test this assumption. We investigated one facet of student safety by comparing college student mortality rates occurring during educational programs abroad with rates occurring on U.S. campuses. Methods: Two insurers provided information about the duration of education abroad experiences for 1,342,405 individuals insured over seven calendar years and details of repatriation of remains claims during that period. Mortality rates for students abroad were calculated and compared with existing data from students on U.S. campuses. Results: Students are less likely to die during study abroad experiences than on U.S. campuses. This is driven by reduced likelihood of death among male students studying abroad. Conclusions: Results can guide staff and student training and policies by providing professionals involved in study abroad with objective information about the relative risk of overseas study and causes of death.

A Global Veterinary Education Program for North American Veterinary Students: A Description of Purdue University Best Practices

Worldwide growth in global mobility has transformed the way we communicate, trade, and approach global issues. The rise of global migration and distribution comes with a higher probability of transmitted disease, human-wildlife conflict, and food safety issues. No longer viewed as isolated incidents, the occurrence of global health threats in one part of the globe is now a concern throughout the world. Our society needs globally conscious veterinarians who are dedicated to affecting world change through the improvement of animal and human health; veterinarians who are prepared to collaborate, exchange, and engage with the world around them. Higher education institutions for veterinary medicine have the responsibility to prepare their students to become agents of change within society and rewrite the narrative on global health. This article highlights the intentional approach that Purdue University College of Veterinary Medicine took to address the need for more globally conscious veterinarians. The article provides examples of administrative structures, funding sources, global engagement opportunities, methods to increase student awareness of opportunities, and student support. Finally, we describe the impact of this approach in increasing student participation in global engagement.

Does Achievement Rise Fastest with School Choice, School Resources, or Family Resources? Chile from 2002 to 2013

Debates in education policy draw on different theories about how to raise children's achievement. The school competition theory holds that achievement rises when students can choose among competing schools. The school resources theory holds that achievement rises with schools' resources per student. The family resources theory holds that achievement rises as parents become more educated and earn higher incomes. We test all three theories in Chile between 2002 and 2013, when reading and math scores rose by 0.2 to 0.3 standard deviations, as school competition, school resources, and family resources all increased. We compare Chilean municipalities in a difference-in-differences analysis, asking whether test scores rose fastest in municipalities with greater increases in school competition, school resources, or family resources. We find that municipal test scores did not rise with school competition but did rise with family resources (parental education, not income) and, to a smaller extent, with school resources (as measured by class sizes). Results favor the family resource theory, and to a lesser extent the school resource theory, but not the school competition theory.

The Impact of Respiratory Therapy International Education in the United States: Saudi International Students' Perceptions

BACKGROUND

The purpose of this study was to assess graduate and undergraduate international respiratory therapy students' perceptions of the impact of their international educational experience on their life experience and development.

METHODS

Data were collected through a validated descriptive survey. Four main dimensions of development were assessed: professional respiratory therapist (RT) role, global understanding, personal development, and intellectual development.

RESULTS

The sample size was 62. Just over half of the subjects held a graduate degree in respiratory therapy, and 47% held an undergraduate degree in respiratory therapy. Female participants accounted for 13% of participants. The dimensions of development that were the most affected for RT undergraduate students were professional RT role and global understanding, whereas personal development was the most impacted area of development for graduate RT students. The time spent abroad for education had a positive correlation with the students' perceptions of development of their professional RT role (r_s = 0.43, P = .001), personal development (r_s = 0.26, P = .047), and overall survey development score (r_s = 0.28, P = .036). Former graduates had a significantly higher perception of development of their professional practice (P = .035) and cultural interaction (P = .03) than did current students.

CONCLUSIONS

International education has a large overall positive impact on students' life experience and development. The study findings support the value of promoting international education in RT programs due to its role in advancing students' development and the internationalization of RT education.

Juggling to survive: Master of Science postgraduate nursing students' experiences of studying far from home

Background

Globally, government and higher education institutions are expected to increase international student numbers. Programme development, marketing international collaboration and management has been the focus of strategy roll out.

Aims

This study aimed to explore international student experiences while undertaking Master of Science postgraduate education far from home.

Methods

A qualitative descriptive design was used. Following ethical approval, 11 students studying on a Master of Science Nursing postgraduate programme in one health education institute in Ireland volunteered to participate. Students were of Asian origin and mixed gender and the average age was 27. Data were collected using face-to-face semi-structured interviews and data analysis followed Burnard's thematic framework.

Results

The data provide evidence of the complexities and challenges experienced when studying on a Master of Science postgraduate nursing programme. Students described a process of juggling to survive and succeed. Three overarching categories emerged: differing realities, working through, and learning new ways.

Conclusions

This study adds to international debate regarding structures and processes supporting international nurse education. In meeting ethnic and culturally-diverse student learning needs, consideration of learning and teaching approaches is warranted. For globalisation in nurse education to prosper, investment needs to move from focusing on recruitment towards structures and processes to nurture intercultural learning.

A Call to Action to Transform Pharmacy Education and Practice in the Arab World

Globally, pharmacy education is evolving to reflect a more patient-centered, interprofessional approach to clinical practice. In the 22 countries of the Arab world, advancements in regulatory support for pharmacy practice and changes to the health care system have been slower than in Europe, Asia, and the Americas. Significant cultural, logistical, and legal barriers exist in many countries, and a consensus approach to accreditation, educational outcomes, and curricula design is lacking. This commentary briefly examines the current state of both pharmacy education and practice in the Arab world, and it highlights recent reports of curricular reform and innovation. Additionally, it provides potential strategies for improving the quality of education and for expanding pharmacy practice to ensure graduates and practitioners have adequate experiential opportunities and institutional support.

Exploring international gender differences in mathematics self-concept

This study provides an international perspective on mathematics by examnnng mathematics self-concept, achievement, and the desire to enter a career involving mathematics among eighth graders in 49 countries. Using data from the Trends in International Mathematics and Science Study, this study shows that self-concept in mathematics is more closely related to the desire to enter a career using mathematics than achievement is. Further, while gender differences in mathematics self-concept are smaller in more egalitarian countries, both girls and boys have lower mathematics self-concepts and less interest in mathematics careers in these countries. These findings reveal a policy paradox: policies aimed at training the next generation of STEM professionals often highlight the need to close the gender gap, but countries with smaller gender gaps have fewer boys and girls interested in mathematics-intensive careers. We conclude by highlighting the importance of disentangling instrumental and expressive aspects of gender inequality in STEM fields.

Adapting to a US Medical Curriculum in Malaysia: A Qualitative Study on Cultural Dissonance in International Education

Context

Minimal research has examined the recent exportation of medical curricula to international settings. Johns Hopkins University School of Medicine in Baltimore, USA partnered with Perdana University Graduate School of Medicine in Kuala Lumpur, Malaysia and implemented the same curriculum currently used at Johns Hopkins University to teach medical students at Perdana University. This study aimed to explore the perspectives of first-year medical students at Perdana University, focusing on issues of cultural dissonance during adaptation to a US curriculum.

Methods

In-depth semi-structured interviews with the inaugural class of first-year students (n=24) were conducted, audio-recorded, and transcribed. Two reviewers independently coded and analyzed the qualitative data for major themes.

Results

The most prominent themes identified were the transition from a “passive” to an “active” learning environment and the friendliness and openness of the professors. Students noted that “[Perdana University] is a whole new, different culture and now we are adapting to the culture.” Being vocal during classes and taking exams based on conceptual understanding and knowledge application/integration proved to be more challenging for students than having classes taught entirely in English or the amount of material covered.

Discussion

This study reinforced many cultural education theories as it revealed the major issues of Malaysian graduate students adapting to a US-style medical curriculum. Despite coming from a collectivistic, Confucian-based cultural learning background, the Malaysian students at Perdana University adopted and adapted to, and subsequently supported, the US learning expectations.

International practice experiences in pharmacy education

OBJECTIVES

To identify reasons for inclusion of international practice experiences in pharmacy curricula and to understand the related structure, benefits, and challenges related to the programs.

METHODS

A convenience sample of 20 colleges and schools of pharmacy in the United States with international pharmacy education programs was used. Telephone interviews were conducted by 2 study investigators.

RESULTS

University values and strategic planning were among key driving forces in the development of programs. Global awareness and cultural competency requirements added impetus to program development. Participants' advice for creating an international practice experience program included an emphasis on the value of working with university health professions programs and established travel programs.

CONCLUSION

Despite challenges, colleges and schools of pharmacy value the importance of international pharmacy education for pharmacy students as it increases global awareness of health needs and cultural competencies.

Factors associated with pharmacy student interest in international study

OBJECTIVES. To examine the interest of pharmacy students in international study, the demographic factors and involvement characteristics associated with that interest, and the perceived advantages and barriers of engaging in international opportunities during pharmacy school. METHODS. A self-administered electronic survey instrument was distributed to first-, second-, and third-year pharmacy students at the University of Kentucky College of Pharmacy. RESULTS. There were 192 total respondents, for a response rate of 50.9%. Seventy-two percent reported interest in international study. Previous international study experience (p=0.001), previous international travel experience (p=0.002), year in pharmacy school (p=0.03), level of academic involvement (p<0.001), and level of diversity involvement (p<0.001) were associated with international study interest. Positive influences to international study included desire to travel and availability of scholarships. Perceived barriers included an inability to pay expenses and lack of foreign language knowledge. CONCLUSIONS. The needs and interests of pharmacy students should be considered in the development and expansion of internationalization programs in order to effectively optimize global partnerships and available international experiences. Colleges and schools of pharmacy should engage students early in the curriculum when interest in study-abroad opportunities is highest and seek to alleviate concerns about expenses as a primary influence on study-abroad decisions through provision of financial assistance.