Collaboration and Sustainability in Short-Term Global Immersion: Ten Years of Experience

For over ten years selected undergraduate nursing students at a southern United States university have participated in a global clinical immersion experience at the same Bahamian site. The program involves a partnership between the Bahamian Ministry of Health, a local non-governmental organization, local primary and secondary schools, faith-based community organizations, and Emory University’s Nell Hodgson Woodruff School of Nursing (NHWSN). The overall goals have been to enhance healthcare in Eleuthera, The Bahamas through building local capacity among professional and non-professional community members and to enhance student learning and professional development through community engagement, application of clinical skills, and self-reflection.

            This global immersion experience has sought to provide clinical services to rural and underserved populations in The Bahamas; to enhance the provision of health promotion and disease prevention education within local schools; and to increase the students’ understanding of traditional healing practices and beliefs along with the role of faith in recovery. The Ministry of Health in The Bahamas and local community-based organizations have benefitted through the enhanced training of Bahamian nurses and the increased understanding of the health-related needs of its population through participation in community-based research and program evaluation. The NHWSN nursing students have reported opportunities to enhance their skills in respect to clinical practice, develop appreciation for cultural humility, and participate in the provision of health promotion and disease prevention education in a global setting.

            In any educational intervention based in a country outside of the institution’s home country there are layers of contacts and relationships, and sometimes differing goals and objectives for the trip. Creating a service learning experience that is meaningful for all parties involved includes closely listening to the needs and wishes of the host country, understanding the priorities for the local community, and incorporating those into the educational objectives for the trip.

            Certain guidelines and philosophical foundations have informed all aspects of these trips. The primary principle framed within the umbrella of community-engaged learning is that of collaboration with entities in the host country, which includes the Ministry of Health, the local island clinics, and key individuals such as the Chief Nursing Officer for the island, and leaders of service and non-profit organizations. It has been essential to the success of the experience for the host country to be an active participant in planning and identifying expected outcomes.

            The Conceptual Model for Partnership and Sustainability in Global Health (2010, J. Leffers and E. Mitchell) provides a framework and theoretical basis for the goals, objectives, and activities for the student immersion experiences. Components of the Emory-Bahamas collaboration described in this presentation support this conceptual model, while at the same time the conceptual model provides focus and definition to a decade of involvement.

            One of the continuing challenges in this program has been to maintain and sustain a relationship with partners at the site that results in positive benefit for all parties involved. Key elements for sustainability include: ongoing communication between faculty and leaders on the island; collaboration between the university, nursing school, and non-governmental organization to implement and support local healthcare projects; and intentional choice of on-site activities that springboard from previous trips to provide growth and development. In addition, systematic evaluation of processes and outcomes is essential to guide revision and identification of “next steps” in the process of sustainability.

            In this presentation, principles that have proven successful for collaboration and sustainability in these educational experiences and the lessons learned from aspects that were less helpful are examined and evaluated.