Barbara Astle

Motivation and international clinical placements: shifting nursing students to a global citizenship perspective.

Abstract Nursing programs are increasingly offering international clinical experiences as part of nursing curricula. The purpose of this study was to understand what motivates student nurses to take part in these experiences. Related to motivation, student awareness of emerging nursing discourses on global citizenship was also examined. As part of a qualitative study, nine undergraduate nursing students were interviewed about their motivations for choosing a clinical placement to a low-income country. While students appeared to have a sincere desire to make a difference, closer examination of the data revealed that the majority approached their international clinical placement in ways that could be construed as paternalistic to some degree, rather than reflective of broader professional imperatives such as social justice. This finding suggests that additional education preparation may be needed prior to these experiences; global citizenship frameworks may be helpful in shifting perspectives towards a more critical enquiry of global issues.

In Real Time: Exploring Nursing Students’ Learning during an International Experience

Abstract Nursing education has increasingly turned to international learning experiences to educate students who are globally minded and aware of social injustices in local and global communities. To date, research with international learning experiences has focused on the benefits for the students participating, after they have completed the international experience. The purpose of this qualitative study was to explore how nursing students learn during the international experience. The sample consisted of eight nursing students who enrolled in an international learning experience, and data were collected in “real time” in Zambia. The students were observed during learning activities and were interviewed three times. Three major themes emerged from the thematic analysis: expectations shaped students’ learning, engagement facilitated learning, and critical reflection enhanced learning. Implications are discussed, related to disrupting media representations of Africa that shape students’ expectations, and educational strategies for transformative learning and global citizenship.

Person-centred care dialectics—Inquired in the context of palliative care

Although a widely used concept in health care, person-centred care remains somewhat ambiguous. In the field of palliative care, person-centred care is considered a historically distinct ideal and yet there continues to be a dearth of conceptual clarity. Person-centred care is also challenged by the pull of standardization that characterizes much of health service delivery. The conceptual ambiguity becomes especially problematic in contemporary pluralistic societies, particularly in the light of continued inequities in healthcare access and disparities in health outcomes. Our aim was to explicate premises and underlying assumptions regarding person-centred care in the context of palliative care with an attempt to bridge the apparently competing agendas of individualization versus standardization, and individuals versus populations. By positioning person-centredness in relation to the hermeneutics of the self according to Paul Ricœur, dialectics between individualization and standardization, and between individuals and populations were constructed. The competing agendas were related in a dialectic manner in the way that population health is of importance for the individual, and standardization is of importance for the population. The analysis suggests that person-centred care is an ethical stance, which gives prominence to both suffering and capability of the individual as a person. The dialectic analysis points towards the importance of extending person-centred care to encompass population and societal perspectives and thereby avoiding a problematic tendency of affiliating person-centred care with exclusively individualistic perspectives. Considerations for person-centred palliative care on micro-, meso- and macrolevels conclude the paper.

Analyzing the quality of ophthalmic nursing research

The purpose of this project was to describe, classify, and analyze ophthalmic nursing research published between 1975 and 1996. Sixty-six quantitative research articles were reviewed. This mainly descriptive body of research covered such topics as assessment/screening, self-care, and risk factors. The research articles were generally rated as superior or average, with many of the average being at the low end of the scale. Twenty-eight percent of the research was not applicable to nursing practice, and 42% had low or no theoretical relevance to nursing. This review will help to establish a research agenda in the area of ophthalmic nursing.

Host perspectives on short-term experiences in global health: a survey

Abstract Background Competencies developed for global health education programmes that take place in low-income and middle-income countries have largely reflected the perspectives of educators and organisations in high-income countries. Consequently, there has been under-representation of voices and perspectives of host communities, where practical, experience-based global-health education occurs. In this study, we aimed to understand what global-health competencies are important in trainees who travel to work in other countries, seeking opinions from host community members and colleagues in low-income and middle-income countries. Methods We performed a literature review of current interprofessional global health competencies to inform our survey design. We used a web-based survey, available in English and Spanish, to collect data through Likert-scale and written questions. We piloted the survey in a diverse group of 14 respondents from high-income, middle-income, and low-income countries and subsequently refined the survey for greater clarity. We used convenience sampling to recruit participants from around the world and included a broad range of coauthors. A website was constructed in English and Spanish and the survey link added. This website and link were distributed as broadly as possible. It was mandatory for survey participants to list their country of birth and current work in order to confirm representation. Findings We received 274 responses: 227 in English and 47 in Spanish between Sept 1, 2015, and Dec 31, 2015. Respondents were from 38 countries across all economic regions. After data cleaning, we included 170 responses (132 in English and 38 in Spanish): 44 (26%) from high-income countries, 74 (44%) from upper-middle income countries, 31 (18%) from lower-middle income countries, and 21 (12%) from low-income countries. Respondents spoke 22 distinct primary languages. In terms of pre-departure competencies, 111 respondents rated cultural awareness and respectful conduct while on rotations as important. For intra-experience competencies, 88 of 112 respondents (79%) thought that it was equally as important for trainees to learn about the local culture as it was to learn about medical conditions. 65 of 109 (60%) respondents reported trainees gaining fluency in the local language as being not important. In terms of post-experience competencies, none of the respondents reported that trainees arrive as independent practitioners to fill health-care gaps. Interpretation Most hosts and partners across economic regions appreciate having trainees from other countries in their institutions and communities. There was a strong emphasis from respondents on the importance of a greater focus on cultural learning and building respect over medical knowledge and clinical practice. Additionally, respondents did not believe that trainees fill important human resource gaps, but are instead being provided with a beneficial learning experience. By gaining insight into host perceptions on desired competencies, global health education programmes in low-income and middle-income countries can be collaboratively and ethically designed and implemented to meet the priorities, needs, and expectations of host communities. Our findings could change how global health education programmes are structured, by encouraging North-South/East-West shared agenda setting, mutual respect, empowerment, and collaboration. Funding Child Family Health International.

Finding our Place: Making the Connection Toward Faith Integration

At the onset, the unfamiliarity of faith integration for nurse educators working within a faith-based university can be challenging. Two nurse educators describe the process they took to learn and navigate faith integration, while teaching undergraduate nursing students. Over the course of one year, various approaches toward faith integration with students were implemented, leading to an authentic relational interconnectedness.