International affairs. International exchange--students and faculty

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 nursing research and educational exchanges: A review of the literature

For more than 40 years, nurses have been involved in international programs and networks established to strengthen nursing education and research in developed and developing countries. After discussing international educational and research exchanges at the American Academy of Nursing's International Expert Panel, we reviewed the state of the literature about these collaborations to evaluate the results. MEDLINE and CINAHL were searched for papers between 1982-2003 on international nursing education exchange programs. The 79 papers identified and reviewed included, primarily, descriptions of or experiences with the exchanges. Most were written by faculty, even though most exchanges were for students. Most papers were written by persons from only one side of the exchange. Literature on this topic needs to begin including a theoretical basis and review of the literature; more research on and evaluation of the effects of these programs is needed.

Curriculum Considerations for Enhancing Baccalaureate Learning for International Students

BACKGROUND

International students studying nursing in the United States present unique teaching opportunities and challenges. Student language, culture, and academic expectations are major factors for faculty to consider in delivering international education.

METHODS

An RN to BSN program provides baccalaureate completion study for registered nurses residing in Israel. Students can choose to complete the final semester in the United States.

FINDINGS

Israeli nursing students demonstrate a strong collectivistic orientation to their academic work. Issues related to English language fluency and academic paper preparation were identified.

CONCLUSION

Success in international teaching endeavors is facilitated when faculty carefully evaluate course materials and assignments. Clarity of language, cultural expectations, and availability of academic resources are important considerations for promoting student success.

Finnish students' perceptions of a visiting professor

Although nurse educators enthusiastically endorse visiting professors, cross-school collaboration, cross-cultural teaching, and international faculty exchange programs, no previous studies have documented students' perceptions of visiting faculty. An open-ended questionnaire was used to identify Finnish students' perceptions of a visiting Fulbright professor and how faculty and students can better prepare for educational exchanges. Four themes emerged from the content analysis of responses to the questionnaire: course content, teaching methods, the role of the teacher, and expectations and developmental challenges. Generally, students were satisfied with the course content and teaching methods. They indicated that it was important that the teacher was encouraging and positive and challenged them to speak up in class. Students commented that the visiting professor should perhaps have been more knowledgeable about and therefore able to make applications to Finnish culture, education, and the health care system. Others noted that it was helpful to learn about the American health care system and then to make applications to Finnish culture themselves. Overall, the findings of this project support continuation of visiting professors and continued research on methods of increasing visiting faculty program effectiveness.

Experiences of Japanese Nurse Scholars: Insights for U.S. Faculty

The purpose of this paper is to describe the international educational experiences of Japanese nurse scholars to develop more understanding within academic settings in the United States (U.S.). Based on Heideggerian phenomenology, interpretive methods were used to analyze 42 interviews. Participants of this study were 22 Japanese nurse scholars who had received or were in the process of receiving master or doctoral degrees from schools of nursing in the U.S., and three Japanese nurse consultants. To build trust and aid with self-disclosure, participants were interviewed up to three times. The analytic process used overlapping strategies, including early identification of principal themes, interpretive writing based on exemplars, and paradigm cases illustrative of major themes. Themes discussed in this paper include: changes in the sense of self; cultural differences in self-disclosure; the importance of the advisor; mental health issues; strategies for support; differences between practices in the U.S. and Japan; and experiences of returning to Japan.

Productive international faculty exchange: one Columbia University to Gothenburg University example

This article describes the preparation, implementation and outcomes of a visiting professor exchange experience from the United States to Sweden, and provides recommendations for other faculty who may be asked to enact a similar international role. The major goals of the visit were to coalesce the themes of the earlier administrative contacts into specific projects, and to model a scholarly faculty role consistent with the Columbia University School of Nursing mission as a World Health Organization Collaborating Centre for International Nursing Development. Professional nursing activities during the exchange visit were comprised of three main categories: teaching, consultation, and socialization. Strategies are described that enhanced the bilingual lectures for the Swedish students. The relationships that developed from consulting at the college and on site at various clinical locations culminated in the mutual identification of collaborative research projects and plans for the cross-cultural adaptation of the author's parent education model. Recommendations are made concerning the range of philosophical, institutional, professional and personal resources needed for international exchanges.

Nursing education and international health in the United States, Latin America, and the Caribbean

PURPOSE

To identify international health activities in United States, Latin American, and Caribbean schools of nursing. In the international community, nurses face challenges similar to those in related professions, but without the benefit of a long tradition. There is little research about how nursing education and associated activities prepare nurses to deal with international health, and little information about the extent of international health activities in U.S. schools of nursing.

DESIGN

Descriptive.

METHOD

Using a questionnaire with 16 items, a survey was conducted in 1995 on a random sample of representatives from 100 university schools of nursing in the United States plus 15 schools with known international activities (10 from the United States and 5 from Latin America and the Caribbean).

FINDINGS

International health as a program topic was found in one-third of U.S. schools of nursing. However, nursing curriculums do not integrate international health with other subjects. Also, partnerships with foreign institutions are incipient and international health activities are usually individual initiatives with little institutional support.

CONCLUSIONS

For nurses to become major contributors to international health, nursing curriculum content must shift from "international nursing" to "international health." Programs of nursing education should include study of social, economic, and political factors that affect health care systems. Schools should develop partnership agreements.

Summers of No Return: Transforming Care Through a Nursing Field School

Nursing education is developing a wide variety of ways to educate for cultural competence that expedites culture-congruent care and effective diversity management in practice. Using a praxis orientation, this article reports research done on an innovative nursing field school during the past four summers on the Pine Ridge Indian Reservation in South Dakota. Learning context emphasizing formation of a collaborative, caring community is created for 6-week immersion learning experiences during which student groups work with the High Plains Oglala Lakota in tribal programs. Triangulated data based on participant observation and student journals, stories, discussions, interviews, academic coursework, and evaluation surveys provide a comprehensive record of complex and multifaceted field school and immersion learning processes. Through collaboration with students, Diekelmann's "Concernful Practices" are tested and adapted for fit as a framework for organizing and examining the field school experience, as well as the practice of health care across cultures.

ROPES: an experiential learning activity for leadership skills

The cluster of activities called ROPES is borrowed and modified for teaching from OUTWARD Bound, the renowned outdoor management training program. ROPES uses experiential learning situations in which characteristic problem-solving tasks encourage the participants to stretch their personal limits and to learn teamwork. In doing so, trust, self-confidence, and communication and leadership skills develop through accomplishment of specific challenging activities. ROPES activities were found to be an effective method of instruction for teaching leadership in a senior nursing leadership course.