Nursing as universal and recognisable: Nursing students'perceptions of learning outcomes from intercultural peer learning webinars: A qualitative study

Midwives' Intercultural Effectiveness Levels and Influencing Factors

INTRODUCTION

Due to globalization, countries around the world are starting to notice diversity in their populations. It is crucial that midwives be able to communicate effectively with women from a variety of cultures to provide them with culturally effective health care.

METHOD

This cross-sectional study was conducted with 394 midwives who work in seven different regions of Türkiye. Data on the intercultural effectiveness and intercultural communication competence of midwives were collected. Data analysis was performed using descriptive statistics, t-tests, analysis of variance, and regression analysis.

RESULTS

Midwives' intercultural effectiveness was influenced by their foreign language proficiency, experiences abroad, having friends from different cultures, following social media platforms in different languages and cultures, providing care to individuals from diverse cultures, and their willingness to do so.

DISCUSSION

Findings suggest that exposure to different cultures enhances the level of intercultural effectiveness. Consequently, it is recommended to make plans to support midwives to have positive experiences with different cultures.

Nursing students' internationalization: Virtual exchange and clinical simulation impact cultural intelligence

BACKGROUND

There is a need for globally competent nurses; however, some cannot train abroad. Internationalization at home strategies seek to teach intercultural and international competencies to all students, regardless of location.

PURPOSE

This study evaluated the impact of a virtual exchange and clinical simulation program on nursing students' cultural intelligence.

METHODS

The Global Nursing Care (GNC) program was designed to improve nursing students' global competencies, particularly cultural intelligence. It was implemented in two universities in Spain and the USA. A quasi-experimental, analytic, and longitudinal study involved 261 nursing students, 57 from the GNC program and 204 in the control group. Sociodemographic data were collected, and the Cultural Intelligence Scale was used to measure cultural intelligence.

DISCUSSION

All cultural intelligence dimensions were augmented following program participation. Moreover, students who participated in the program presented higher cultural intelligence than the control group.

CONCLUSION

The results suggest that program participation was associated with a statistically significant gain in nursing students' cultural intelligence.

The influence of social media on student nurses: A systematic mixed-studies review

BACKGROUND

Social media usage has been ubiquitous and extensively integrated into the daily lives of student nurses. However, there exists a paucity of understanding regarding the influence of social media on student nurses' personal and professional development.

OBJECTIVE

To examine the influence of social media on student nurses' personal and professional values.

DESIGN

A systematic mixed-studies review.

METHODS

English language published studies were sourced from hand searches and seven electronic databases (PubMed, CINAHL, Embase, PsycINFO, ProQuest Dissertation and Theses Global, Scopus, and Web of Science) from the inception of each database to January 2023.

RESULTS

Twenty-six studies were included. Two main themes and eight subthemes were derived through thematic synthesis. The first main theme, Shaping Student Nurses into Nurses, included four subthemes: 1.1) Personal Development, 1.2) Professional Development, 1.3) Advocacy, and 1.4) Networking. The second main theme, Repercussions of Social Media Usage, included four subthemes: 2.1) Frustrations, 2.2) Discriminative Feelings, 2.3) Compulsive feelings, and 2.4) Consequences of Inappropriate Usage.

CONCLUSION

The ubiquitous utilization of social media among the current generation of student nurses, for personal, educational, and professional purposes, has precipitated transformative effects conducive to their holistic development. Notwithstanding the potential perils associated with privacy violation and inappropriate usage, educational institutions can develop pedagogical strategies and guidelines in collaboration with healthcare institutions and professionals, aimed at the incorporation of social media within the educational curricula and the prospective workplace environments of student nurses.

Does the cultural awareness of nurses affect brain drain and xenophobia?

AIM

Turkey is on the transit route of immigrants as it is located between countries where poverty and wars are intense and European countries. Therefore, there are countless immigrants from different countries in Turkey. Migrations affect every sector, especially the health sector. The aim of this study was to determine how cultural awareness of nurses, who are the cornerstone of the health system, affects brain drain and xenophobia. The problem of health care is not only on the agenda of immigrants, but also on the agenda of health service providers in their countries due to economic and working conditions.

DESIGN

This research was designed as descriptive and relationship-seeking.

METHODS

The data of the research were collected through Google Forms between December 5 and 26, 2022. A total of 231 nurses working in a public hospital in south-east Turkey participated in the study. Data were evaluated with descriptive statistics as well as reliability, t-test, ANOVA, Pearson correlation and linear regression analysis.

RESULTS

It was determined that the attitudes of the participants towards brain drain were moderate, their cultural awareness was low and their xenophobic attitudes were high. In addition, it was determined that 44% of the change in the total score obtained from the intercultural awareness scale was explained by the scores obtained from the xenophobia and brain drain scales.

CONCLUSIONS

In this context, it may be possible to reduce xenophobic attitudes by giving intercultural awareness trainings to nurses. In addition, it is important to provide working conditions and economic support by health policy makers to prevent the brain drain of nurses.

IMPACT

Nurses may need to provide care for individuals from different cultures due to the regions in which they live. For this reason increasing their cultural awareness and reducing xenophobia may ensure that they provide improved care to their patients.

Facilitating a Virtual International Experience for Undergraduate Students: Creating Global Awareness and Connection

BACKGROUND

Preparing nursing students for practice is supported by developing a global perspective of health care delivery models. However, many schools of nursing and students lack the resources for study abroad.

METHOD

Using a virtual stay-in place model, 42 international students applied an evidenced-based approach to study statistics, research, transitions in care, and elder care models that supported collaboration among peers from Austria, Switzerland, Chile, the United Kingdom, and the United States. Students explored social, economic, and reimbursement factors not encountered in the typical classroom.

RESULTS

Student beliefs and perspectives changed after completing a program with global peers. Survey results and themes in reflection papers indicated increased ability to conceptualize content in new ways, including holistic elder care, cultural practices and reimbursement options, and effects on future practice.

CONCLUSION

Virtual international learning experiences are an effective education innovation that allows student to connect and learn from one another using a stay-in place model. [J Nurs Educ. 2023;62(11):647-649.].

Nursing Students' Experiences of a Student-Led Collaborative Online International Learning Program

AIM

The aim of the study was to explore undergraduate nursing and midwifery students' perspectives of participating in a student-led collaborative online international learning (COIL) program.

BACKGROUND

Research on COIL programs is limited. This program, developed across three global universities, was implemented to provide an internationalization-at-home experience for students during the COVID-19 pandemic.

METHOD

An exploratory descriptive qualitative design was employed using nursing students' reflections and interviews.

RESULTS

Data analysis revealed four key themes: student-led learning experiences, personal gains, influence on professional practice, and becoming a global citizen. Students' experiences offer insights into positive aspects of the program and highlight challenges to overcome.

CONCLUSION

The student-led COIL experience increased nursing students' understanding of the dynamics of culture and nursing practices across different countries. Students' personal growth and professional gains will potentially prepare them to work in multicultural environments and develop global citizenship attributes.

From a learning opportunity to a conscious multidimensional change: a metasynthesis of transcultural learning experiences among nursing students

BACKGROUND

Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training.

METHODS

A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data.

RESULTS

Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge.

CONCLUSIONS

Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking.

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.

A scoping review of international virtual knowledge exchanges for healthcare professionals

International knowledge exchanges within healthcare have historically been a popular method to provide exposure to practice in other national and international healthcare settings. As the COVID-19 pandemic forced many countries into lockdowns, knowledge exchanges in healthcare were forced into a period of suspension. This provided an opportunity to consider alternative methods of delivery. This scoping review explores virtual knowledge exchanges in healthcare professional education, including their format and related outcomes. Thirty-four virtual knowledge exchanges were identified. These demonstrated viability and subjective participant satisfaction. Virtual methods removed barriers of time, distance and finance associated with traditional exchanges, while still facilitating engagement with other international healthcare colleagues. However these exchanges were heterogeneous in their aims, structure and theoretical underpinnings. An understanding of educational outcomes and their measurement was not always obvious. Applying an overlay of robust pedagogical theory would strengthen and provide structure to the clearly well valued activity of international exchange.

The relationship between intercultural effectiveness and intercultural awareness and xenophobia among undergraduate nursing and vocational schools of health services students: A descriptive study

BACKGROUND

Students who will become health professionals should be educated according to universal standards of providing foreign patients with culturally satisfying health care, free from discrimination.

AIM

This study aims to identify the relationship of intercultural effectiveness and awareness with xenophobia in undergraduate nursing students and vocational schools of health services students.

METHOD

This descriptive study was conducted with undergraduate nursing students (N= 257) and vocational schools of health services students (N = 341) in a region with a high refugee population in Turkey. Data were collected through the "Intercultural Awareness Scale," the "Intercultural Effectiveness Scale," and the "Xenophobia Scale."

RESULTS

Of all the participants, 70.1% were females, and the mean age was 20.70 ± 2.64 years; 57% of the students were from the vocational school students, and 43% from the undergraduate nursing program. Female students had significantly higher scores in intercultural effectiveness, behavioral flexibility, xenophobia (p = 0.036, p = 0.041, p = 0.001, respectively), interaction relaxation and interactant respect (p < 0.001, p < 0.001), while male students had significantly higher intercultural awareness (p < 0.001). The median intercultural effectiveness score of the students living in the rural area was low (p = 0.044), and the median xenophobia score of the students who lived abroad was significantly lower (p = 0.032). There was a negative correlation between the Intercultural Effectiveness Scale total and Intercultural Awareness and Xenophobia Scale total mean scores (r = -0.085, r = 0.182), and there was a weak, positive correlation between the Intercultural Awareness Scale total mean scores and the Xenophobia Scale mean scores (r = 0.113).

CONCLUSION

Intercultural sensitivity is considered to be improved by including course content in the curriculum to improve students' intercultural effectiveness and awareness levels and decrease their xenophobic prejudices.

Usability and value of a digital learning resource in nursing education across European countries: a cross-sectional exploration

Background

Higher education is responsible for providing education that meets international benchmarks relevant to the needs of the international community. Due to the increase of digital tools in higher education, the possibility of sharing learning resources across nations has expanded. In the current project, a Norwegian university invited universities in Spain and the United Kingdom to adapt and translate e-learning resources originally developed for Norwegian nursing students for use within their respective Bachelor in Nursing programmes.

Aim

The aim of the current study was to gain insights into the usability and value for learning of e-compendiums shared and implemented across three European universities.

Methods

The study adopted a descriptive cross-sectional design and included nursing students from the University of Nottingham, Valencia Catholic University, and the University of Stavanger. Data were collected in Autumn 2017 through a questionnaire adapted from the validated “Centre for Excellence in Teaching and Learning Reusable Learning Object evaluation questionnaire” The questionnaire consisted of 19 items that included two aspects: e-compendiums’ value for learning and e-compendiums’ usability. The different study sites were compared using a binary logistic regression analysis. Subgroups of students were compared based on their gender and age.

Results

A total of 480 nursing students participated in the study. The e -compendiums were overall positively rated, especially for reinforcing and retaining knowledge. Compared to the students from the University of Stavanger, students from Valencia Catholic University rated the e-compendiums more positively in most aspects of learning. Students from University of Nottingham found the e-compendiums to be more important for learning engagement compared to students at the Norwegian study site, and no differences were found in any other aspects of learning. Younger students rated the interactivity and visual components as more important compared to older students.

Conclusions

Students from the University of Nottingham and Valencia Catholic University seem to accept the e-compendiums despite the fact that they were originally developed for use in another country. We argue that, when sharing e-learning resources across countries, an adaptation and translation process that includes a multicultural and multidisciplinary perspective should be carried out.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00681-5.

Students' knowledge on intestinal ostomies before and after an online educational platform intervention

OBJECTIVES

to evaluate undergraduate nursing students' knowledge about intestinal ostomies before and after an educational intervention via an online platform.

METHODS

before and after one-group type quasi-experimental research, carried out with 90 undergraduate nursing students from two higher education institutions in Piauí, from July to October 2014. For knowledge assessment, an instrument validated in Brazil was used. Nonparametric inferential statistics was used to compare the pre-test and post-test averages.

RESULTS

there was an increase in the average number of correct answers for undergraduate students after intervention in the online educational platform, from 23.67 (SD = 5.9) in the pre-test to 32.01 (SD = 2.72) in the post-test, and this difference was statistically significant (p = 0.000).

CONCLUSIONS

intervention via online educational platform is considered applicable for teaching undergraduate nursing students on intestinal ostomies.

Learning Outcomes of Digital Learning Interventions in Higher Education: A Scoping Review

Implementing digital technologies has become a policy priority worldwide among all types of education. The COVID-19 pandemic has further accelerated educational institutions' efforts to reorganize their teaching and introduce new digital learning technologies. Although using digital technologies in higher education, including nursing, is considered a modern and innovative way of teaching and learning, uncertainty exists concerning these technologies' actual usefulness in achieving positive learning outcomes. The aim of this scoping review was to examine the current evidence related to the effects of using digital technologies on learning outcomes in higher education. The authors searched five electronic databases for relevant studies and used a scoping review method to analyze and synthesize the evidence. Eighty-six articles from six disciplines met the selection criteria. As a key finding, the outcomes of the interventions were mainly positive. Increased professional knowledge, skills, and attitudes reflect the advancement of professional competence. Academic, collaborative, and study skills, in turn, contribute to general competence development. Our findings suggest that digital technology has the potential to improve learning in various disciplines.

Digital Learning Interventions in Higher Education: A Scoping Review

This scoping review was undertaken to synthesize and describe research related to digital learning interventions in higher education, focusing on technological outcomes. Five electronic databases were searched, and 86 articles were included in the review. The data related to positive and negative technological outcomes and authors' suggestions were analyzed using inductive content analysis. The articles represented six disciplines across six continents and included quantitative (n = 65), qualitative (n = 3), and mixed-methods (n = 18) intervention studies. For positive technological outcomes, digital formats of learning were considered effective and participatory forms of learning in a majority of the articles. The students appreciated individualized and self-paced learning, and the digital form increased their motivation to learn. Automatized technical solutions that enabled learning and teaching had several advantages, and digital learning was believed to save the resources of students, teachers, and organizations. For negative technological outcomes, the technical difficulties in using the digital devices or platforms were described the most, and a need for resources was identified. Feedback from teachers was considered important from positive and negative viewpoints. Authors' suggestions for future digital teaching and learning as well as related interventions consisted of various activities, resources, environments, and methods.

Maximising intercultural learning opportunities: learning with, from and about students from different cultures

Nurses continue to experience challenges when caring for culturally diverse patients and while working with staff from different cultural, ethnic and linguistic backgrounds. The widening landscape of cultural diversity in the nursing classroom provides a vehicle for intercultural learning, supporting intercultural competence development. However, students must embrace culturally diverse learning environments and maximise opportunities to learn with, from and about students from different cultural backgrounds. This requires developing the courage, curiosity and commitment to maximise all intercultural learning opportunities. Drawing on experiences of international students studying in culturally diverse classrooms, this article presents some practical suggestions for meaningfully engaging and capitalising on intercultural learning opportunities.

Learning objectives of cultural immersion programs: A scoping review

BACKGROUND

Cultural immersion as a learning activity provides students with the opportunity to experience diversity and develop cultural safety. Both, 'Study Abroad Programs' and 'Internationalisation at Home' (IaH) aim to provide a cultural immersion experience for students. However, explicit learning objectives are essential for quality pedagogy and for students to develop cultural safety from their learning experience.

OBJECTIVE

To identify the learning objectives of study abroad and Internationalisation at Home (IaH) programs in higher education health profession programs.

DESIGN

A scoping review was undertaken according to recommendations by the Joanna Briggs Institute (Peters et al., 2020) and PRISMA guidelines.

DATA SOURCES

The electronic databases CINAHL, MEDLINE, PsychINFO and PubMed and were searched in November 2019 and updated September 2020. The search was limited to qualitative studies, text and opinion pieces, English language, published between 2015 and 2019.

REVIEW METHODS

Inclusion criteria using the participants, concept, and context (PCC framework) was utilised and search terms such as study abroad and Internationalisation at Home were combined with learning objectives to identify articles. The articles were screened for eligibility by title, abstract, and full text review by two independent reviewers. A data extraction tool was utilised to extract and synthesise data into categories that represent the core learning objectives of cultural immersion programs reviewed.

RESULTS

Fourteen of the 66 initially identified studies were included in this scoping review. Qualitative synthesis yielded five broad categories of learning objectives used in cultural immersion programs: cultural competence, internationalisation, pedagogy, collegiality, and personal growth.

CONCLUSION

A minimum set of essential learning outcomes was derived from this review that will be of interest to developers and implementers of cultural immersion programs.

Formative peer assessment in higher healthcare education programmes: a scoping review

OBJECTIVES

Formative peer assessment focuses on learning and development of the student learning process. This implies that students are taking responsibility for assessing the work of their peers by giving and receiving feedback to each other. The aim was to compile research about formative peer assessment presented in higher healthcare education, focusing on the rationale, the interventions, the experiences of students and teachers and the outcomes of formative assessment interventions.

DESIGN

A scoping review.

DATA SOURCES

Searches were conducted until May 2019 in PubMed, Cumulative Index to Nursing and Allied Health Literature, Education Research Complete and Education Research Centre. Grey literature was searched in Library Search, Google Scholar and Science Direct.

ELIGIBILITY CRITERIA

Studies addressing formative peer assessment in higher education, focusing on medicine, nursing, midwifery, dentistry, physical or occupational therapy and radiology published in peer-reviewed articles or in grey literature.

DATA EXTRACTIONS AND SYNTHESIS

Out of 1452 studies, 37 met the inclusion criteria and were critically appraised using relevant Critical Appraisal Skills Programme, Joanna Briggs Institute and Mixed Methods Appraisal Tool tools. The pertinent data were analysed using thematic analysis.

RESULT

The critical appraisal resulted in 18 included studies with high and moderate quality. The rationale for using formative peer assessment relates to giving and receiving constructive feedback as a means to promote learning. The experience and outcome of formative peer assessment interventions from the perspective of students and teachers are presented within three themes: (1) organisation and structure of the formative peer assessment activities, (2) personal attributes and consequences for oneself and relationships and (3) experience and outcome of feedback and learning.

CONCLUSION

Healthcare education must consider preparing and introducing students to collaborative learning, and thus develop well-designed learning activities aligned with the learning outcomes. Since peer collaboration seems to affect students' and teachers' experiences of formative peer assessment, empirical investigations exploring collaboration between students are of utmost importance.

Intercultural readiness of nursing students: An integrative review of evidence examining cultural competence educational interventions

With the mounting reports of culturally insensitive care and the reported challenges nurses experience when caring for culturally diverse patients, developing the intercultural readiness of nursing students is a necessity. However, little is known as to the success of cultural competence educational interventions in undergraduate nursing curricula and there remains a lack of consensus within the literature as to how it should be structured, organised and facilitated. Incorporating an integrative review method, this study synthesised international research on educational interventions used in preparing student nurses to care for culturally diverse patients. A systematic literature search of all published studies between 2013 and 2017, in CINAHL, Scopus, Medline, PubMed, Embase, Cochrane, Education Source and PsycINFO databases were performed. The PRISMA checklist was used to guide the review process. Six hundred and twenty-four studies were screened for eligibility and the analysis of the fourteen included studies are presented within two overarching themes; increasing knowledge and understanding and developing commitment and confidence. Engaging student nurses in learning activities that augment their understanding of, and commitment to, providing culturally competent care must include a variety of integrated culturally responsive pedagogical approaches made explicit and continuously developed across all learning opportunities.

Globally networked learning: Deepening Canadian and Danish nursing students' understanding of nursing, culture and health

BACKGROUND

Providing intercultural learning experiences that assist students to develop cultural awareness and culturally safe nursing care is an important part of nursing education in Canada and Denmark. However, providing opportunities for students to study and travel to another country can be challenging given the strict requirements to meet entry-to-practice competencies and the timing of clinical placement courses. In an attempt to increase opportunities for students, an innovative strategy called Globally Networked Learning (GNL) that uses the internet and social media, was developed to enable Canadian and Danish nursing students to collaborate and complete a clinically oriented assignment.

OBJECTIVES

This study aims to explore three research questions. What are the students' experiences with GNL? How did GNL influence understanding of how culture, nursing care and health systems influence health outcomes? Can GNL support students to develop a global understanding of health and nursing?

DESIGN

A qualitative study was conducted to explore the students' experiences and learning from their participation in GNL.

SETTING

A school of nursing in Canada and one in Denmark were used as sites for this study, although the collaborative learning experience occurred online.

PARTICIPANTS

In total, 24 BScN nursing students completed GNL projects (12 from Canada and 12 from Denmark) and 15 students (six Canadian and nine Danish) participated in this study.

RESULTS

Students reported very positive experiences with using GNL to complete an assignment that was structured to support inter-cultural learning. Completing the GNL assignment enhanced students' understanding of the global reach of nursing, how culture influences nursing practice and how considering cultural differences enabled them to learn from each other to improve their nursing practice at home.

CONCLUSIONS

GNL is a promising education strategy and plans for expanding GNL in nursing education are proposed.