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Chapter 29
- 1. Chapter 29 Study Abroadas a Strategy for Nursing Education
- 2. Study Abroad asa Strategy for Nursing Education • Importance of Study Abroad Programs for Students’ Education • Overview of the Growth of Study Abroad Programs • Common Goals of Study Abroad Programs • Study Abroad in Health Professions Versus Mission Trips
- 3. Study Abroad asa Strategy for Nursing Education • Faculty and Student Experiential Learning in Eastern Europe: Brasov, Romania • Guidelines for Setting up a For-Credit, Elective, Study Abroad Program for Student Nurses • Setting up for Success
- 4. Study Abroad asa Strategy for Nursing Education • The United States is experiencing the largest sustained immigration wave in its history. • 15% of the U.S. population is comprised of people from Latin American (both legal and illegal immigrants). • The United States accepts more legal immigrants as permanent residents than any other country in the world.
- 5. Importance of StudyAbroad Programs for Students’ Education • As a result of globalization, nursing graduates are likely to care for individuals from diverse cultural and ethnic backgrounds and may find themselves in work settings outside the United States. • Increase in global immigration has changed the cultural tapestry of American society. • Immigration has challenged public and private institutions to respond to groups that are of different religions, cultural beliefs, and traditions.
- 6. Importance of StudyAbroad Programs for Students’ Education • The challenge to gain a more multicultural perspective of health and traditions of health care is particularly essential among nurses. • Clients from cultures other than that of the nurse often do not benefit from nursing care because of miscommunications, misunderstandings, and/or conflicts of values, beliefs, norms, and attitudes between themselves and the nurse.
- 7. Importance of StudyAbroad Programs for Students’ Education • Cultural competence is an ongoing process of seeking cultural awareness, cultural knowledge, skill, and cultural encounters. • Maintaining an open attitude in examining one’s own prejudices, attitudes, and stereotyped perceptions is essential before one can learn about people of other cultures.
- 8. Importance of StudyAbroad Programs for Students’ Education • It is not the client’s responsibility to be understood, but the nurse’s responsibility to understand and meet the client’s needs.
- 9. Overview of theGrowth of Study Abroad Programs • Study abroad programs can be effective in facilitating students in gaining a more global perspective, including cultural understanding of individuals from different health traditions, is an evolving component of their role as educators. • The goal of study abroad programs is to expand students’ perspectives of the world, promote a sensitivity to beliefs and traditions different from their own, and promote a sense of intellectual openness.
- 10. Overview of theGrowth of Study Abroad Programs • Study abroad education provides students with a distinct advantage upon graduation. • An increasing number of healthcare corporations are looking for candidates who have the ability to communicate and work with people from various cultural backgrounds.
- 11. Common Goals ofStudy Abroad Programs • Personal growth and experiential learning • A global perspective of the world • Career enhancement
- 12. Common Goals ofStudy Abroad Programs • Personal Growth and Experiential Learning – Faculty and students who return from a study abroad program often see it as an experience that matured them personally and intellectually. – They praise being exposed to new ways of thinking and living, which encourages growth and independence.
- 13. Common Goals ofStudy Abroad Programs • Broad Perspective of the World – Study abroad can broaden intellectual horizons and deepen knowledge and understanding of international, political, social, and economic issues. – A person learns how others view the United States and its world role.
- 14. Common Goals ofStudy Abroad Programs • Career Enhancement – Study abroad can enhance employment prospects, especially in health care, informatics, international affairs and government service. – Employers increasingly seek graduates who have studied abroad.
- 15. Study Abroad inHealth Professions Versus Mission Trips • Study abroad in health professions provide students with specific goals and objectives to achieve within an academic setting. • The emphasis is intellectual, professional, and objective. • Mission trips have similar goals, but they also have a religious, political, or economic focus.
- 16. Faculty and StudentExperiential Learning in Eastern Europe: Brasov, Romania • Background • Creation of an Eastern European Nursing Collaboration • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei
- 17. Faculty and StudentExperiential Learning in Eastern Europe: Brasov, Romania • Background – The need for palliative care for patients with malignant disease in southeast Europe is immense. – In 2002, Romania had one practicing physician for every 580 people.
- 18. Faculty and StudentExperiential Learning in Eastern Europe: Brasov, Romania • Background – Many people do not seek health care because of fear. – Education regarding prevention, early diagnosis, and treatment is lacking, and healthcare costs are assumed by individuals and their families.
- 19. Faculty and StudentExperiential Learning in Eastern Europe: Brasov, Romania • Creation of an Eastern European Nursing Collaboration – Establishing collaborative nursing education and practice programs ultimately improves clinical experiences and patient care.
- 20. Faculty and StudentExperiential Learning in Eastern Europe: Brasov, Romania • Creation of an Eastern European Nursing Collaboration – The vehicles for collaborative education included clinical site visits at home, visits at the inpatient hospice, and continuing education programs with the Romanian nurses via on-site conferences. The collaboration was sustained following return of the visit by teleconferencing, research, and publications.
- 21. Faculty and StudentExperiential Learning in Eastern Europe: Brasov, Romania • Creation of an Eastern European Nursing Collaboration – In the beginning, cultural and language differences challenged the growth of the collaboration – In Romanian hospitals, clinical nursing practice does not change according to the new findings in the research field.
- 22. Faculty and StudentExperiential Learning in Eastern Europe: Brasov, Romania • A current emphasis on developing nursing literature, obtaining skill for writing articles, and expanding support for palliative care training programs in remote countries affiliated with the Hospice of Hope are the current priorities of the NEA.
- 23. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Objectives – Setting up the Program – Nursing Student Experiences – Forging the Educational Initiative – Student Prerequisites and Preparation – Recruitment of Students for the Trip
- 24. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Orientation – Donations of Supplies and Equipment – Educational Planning for the Visit – Teleconferencing – Course grade requirements – Student course evaluations
- 25. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Objectives • Explore personal attitudes and beliefs about patients in Brasov, Romania. • Examine structure and function of healthcare delivery to patients in hospices and patients receiving palliative care in Brasov and Bucharest.
- 26. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Objectives • Explore main health issues identified by local communities, including the Roma or gypsy community. • Participate in healthcare delivery. • Improve Romanian Language Skills • Explore health beliefs and cultural customs.
- 27. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Setting up the Program • The initial process in developing the nursing experience in Brasov began with a visit to the area to determine the feasibility of establishing a 2-week intensive study abroad nursing course.
- 28. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Setting up the Program • The NEA team visited Romania and practiced with nursing colleagues biannually in 2005–2011. • Quarterly teleconferences with the Romanian nurses have deepened the professional relationship.
- 29. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Nursing Student Experiences • Face-to-face contacts provided opportunities to develop an understanding of cultural differences, discuss expectations regarding educational approaches, and begin to establish a relationship based on mutual respect.
- 30. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Nursing Student Experiences • The visiting American students and team members accompanied the hospice nurses on their home visits • In their journals and in postconference meetings, the students noted that meeting patients and hearing their stories was engaging and saddening.
- 31. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Nursing Student Experiences • ELNEC – End –of-Life Nursing Education Curriculum • Focuses on pain and symptom management, communication and culture, care at the time of death, and grief
- 32. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Forging the Educational Initiative • The students and the faculty team discussed a number of alternatives for responding to the request from Romania. • Teleconferencing was identified as the most cost-effective approach, although they had no equipment.
- 33. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Forging the Educational Initiative • The administrators from Hospice Casa Sperantei began looking for a source of funding for the project, and a well-known philanthropic organization donated the equipment and oversaw the installation
- 34. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Student Prerequisites and Preparation • Prerequisites for all student nurses included having completed at least the initial core graduate nursing courses with a clinical component, giving them skills in advanced health assessment. • Most students were more advanced
- 35. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Student Prerequisites and Preparation • Reading material assignments were given along with the student course syllabus so that students could prepare for their experiences ahead of time • Payment included health insurance, emergency air evacuation and immunizations.
- 36. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Recruitment of Students for the Trip • Fliers, information sessions, financial info
- 37. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum – Orientation • 3 sessions about 3 months prior to trip • Group discussion addressed lodging, personal safety needs, documents, money, packing needs, special health challenges, housing, transportation, working in the field and in hospices, group dynamics and collaboration, culture shock and adjustments, cultural excursions, and cultural sensitivity and appropriate dress and behavior
- 38. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Donations of Supplies and Equipment • Romanian nurses did not have sufficient medical supplies for the patients being treated • Supplies assembled from a variety of sources and brought with the team.
- 39. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Educational Planning for the Visit • Specific topics were picked by the Romanian hospice director • Us Team Members were paired with Romanian nurses to accompany them on home visits. • Romanian nurses lacked confidence and US nurses could validate and encourage them.
- 40. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Teleconferencing • Teleconferencing is a very flexible and cost-effective teaching strategy. • In the United States, clinical supervision and education of 10 psycho-oncology staff was provided monthly through the use of videoconferencing. One-hour educational programs were followed by 1-hour discussions.
- 41. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Teleconferencing • Several topics were suggested by the Romanian team and addressed on a scheduled basis. • Electronic communication has presented opportunity to advance practice methods and provide validation for nursing actions.
- 42. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Course Grade Requirements • The student work was graded according to the expectations and outcomes outlined in the course syllabi. • Students were required to attend all pre- and post-practice conferences, as well as participate in the hands-on clinical work with the Romanian nurses.
- 43. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Course Grade Requirements • All students were asked to keep a journal in the format of critical reflective thinking. Their feelings, thoughts, responses, observations, and activities were recorded.
- 44. Faculty and StudentExperiential Learning in Eastern Europe: • The Nursing Practicum in Brasov, Romania, at Hospice Casa Sperantei – Student Course Evaluations • Formative and summative evaluations usually provide valuable information about immersion experiences. Reported student observations during and after the visits can be helpful in shifting day-to-day priorities and course objectives to improve the experience for the future.
- 45. Guidelines for Settingup a For-Credit, Elective, Study Abroad Program for Student Nurses • Create a proposal • Obtain support from the University • Make a preparation visit to the proposed location • Meet with a tourist travel agency • Recruit Students • Plan and document the experience while at the location
- 46. Setting up forSuccess • 1. Always write a code of behavior, emphasize it at recruitment, at orientation, and during the visit to the host country. Have students sign the behavior code. • 2. Always have health insurance with evacuation coverage for all students and faculty. It is very reasonable. Do not rely on local healthcare facilities for serious accidents or illnesses. For minor problems, they usually will be fine.
- 47. Setting up forSuccess • 3. Make sure that all students stay in the local city at all times and spend the night with host families every night. • 4. Review safety precautions for money (under-the-clothing money bags for traveling) and locking valuables such as passports, money, credit cards, and cameras with their host family.
- 48. Setting up forSuccess • 5. Constantly remind students about what and where is safe to eat and drink, and be sure that they are always aware. • 6. Always watch luggage and carry-ons at airports. Things may disappear very quickly, especially in developing countries, if they are valuable and unattended.
- 49. Setting up forSuccess • 7. Be prepared to deal with culture shock. Language, customs, and in some locations tremendous, never-before-seen poverty can overwhelm faculty and students. Many poor people, including those begging in the streets, can be overwhelming. Giving away prepared sandwiches and fruit or bread can be a group activity that can help some of the overwhelming feelings of frustration.
- 50. Setting up forSuccess • 8. Have students always travel in groups and always carry information with them regarding their host family homes and contact information for reaching faculty 24/7. • 9. Always be available to students 24/7. This is not like the responsibility of a classroom on campus.