Facilitating Cultural Competence Through an Innovative International Collaborative Nursing Partnership

Monday, 18 November 2019: 3:05 PM

Sharon Elizabeth Metcalfe, EdD, MSN, RN
School of Nursing, Western Carolina University, Asheville, NC, USA

With the increasing diversity of the world’s population, today’s schools of nursing and health care educators are faced with the challenge of preparing the next generation of nurses with a broader awareness to provide care with the knowledge of cultural competence towards patients of all backgrounds (Kohlbry, 2016). Cultural competence is the development of an awareness of another’s culture which includes its health beliefs, wellness, and illness characteristics that are different than one’s own beliefs (Maltby, de Vries-Erich, & Lund, 2016). Novice nursing students have limited cultural awareness of the global society and populations of people that reside in countries that are at a distance and different than their own (Curtin, Martins, & Schwartz-Barcott, 2014).

Despite the advent of the internet, as well as global communication such as email, the reality of caring for patients from a variety of cultural backgrounds is difficult to understand for students without the lived experience of being able to travel and care for patients abroad (Gilliland, Attridge, Attridge, Maize, & McNeill, 2016). The theoretical framework of Mezirow’s transformative learning may be used as the underpinning of the foundation for nursing educators to embrace international learning (Strange & Gibson, 2017). Mezirow’s (2009) classic theory is used to describe how people develop and use critical self-reflection to consider their beliefs and experiences, and change their own unique perspectives of the world and its people over time. Study abroad opportunities allows novice students to engage in active learning and critical reflection regarding their individualized patient care experiences. These opportunities allow once in a lifetime experiences for students to reflect on both the similarities and the differences they witness in healthcare within a different country from their own (Simm & Marvell, 2015). Mezirow believed that a person would change their world view of both people and a situation when facing a “disorienting dilemma”, which is an experience that doesn’t fit into the person’s current beliefs about the world (Howie & Bagnall, 2013). Students often discover that international travel experiences in which they learn to care for a population of patients that are different and unique from one’s own is a transformative experience that enriches their world perspective and increases their knowledge base of cultural nursing care (Kronk, Weiderman, Cunningham, & Resick, 2015).

Brown and Boateng (2016) found that study abroad programs have significant benefits such as promoting cultural understanding and acknowledging the differences in healthcare settings, policies and practices. Bamber (2015) found that pedagogical approaches such as utilizing international service learning opportunities with students helps to develop and cultivate a cosmopolitan orientation to the world and healthcare. Cosmopolitanism is considered the acquisition of becoming other-wise for gaining cultural awareness and cultural competence.

This presentation describes the establishment of a unique and innovative, collaborative pediatric global mentoring partnership between two universities and two pediatric hospitals in the United Kingdom and the United States. Based upon the clinical nursing research findings that have been evident in the nursing literature, an international collaborative educational pediatric program and partnership was initiated in 2007. The program has been in existence for eleven years and has engaged over 120 nursing students in learning and understanding cultural competence through care of children in the United Kingdom and the United States. This program is presented each academic year, and students from the United States travel to the United Kingdom over Spring Break, and students from the United Kingdom travel to the United States during the winter break for their clinical education.

The primary goal of this program has been to facilitate the acquisition of knowledge of cultural competence of families and care delivery of pediatric patients from a different country than one’s own for the nursing students. This goal has been accomplished through facilitating novice nursing students in developing an understanding of differences and similarities in pediatric patient care through family dynamics, society, social structures, and healthcare delivery systems in socialized and privatized societies. Students are assigned clinical mentors for caring for pediatric patients, as well as delivery of formal presentations on a topic of interest regarding health care issues. Topics such as childhood obesity, diabetes, mental health issues, and autism found prevalent in pediatric care are presented to their peers in the host country. Additionally, students are assigned in-depth reflective journals that consist of insightful questions regarding the acquisition of knowledge of cultural competence with the patients and families that they are caring for in another country. Using reflective journals, students can pause and contemplate the value of their learning in the overseas course and broaden their perspective of cultures and people that are different than their own. Students from both countries are also able to bring home new knowledge to share with other students and nurses regarding the pediatric care delivery that they have learned on their journey.

International educational nursing programs such as the pediatric mentoring program provide a wealth of novel experiences and adventures. These experiences help nursing students to view the world in different perspectives and viewpoints when learning to care for pediatric patients. In this collaborative program, nursing students have had the opportunity for individualized and intensive mentoring with a clinical nursing mentor that has helped and facilitated their learning into one of being truly transformative. Students have had the ability to embrace new ways of understanding and changing their own ways of thinking to learn transcultural beliefs, values, and cultural awareness in traveling and participating in this program. Both university schools of nursing and pediatric hospitals have also been enriched by the years of valuable experiences and professional friendships that have developed. It is hoped that this presentation will both interest and encourage other schools of nursing and pediatric hospitals to inquire and initiate programs of this kind that are invaluable to student learning.

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