Due to the intense, rigorous workload of nursing students, and their demanding, structured school schedule, it is often very difficult to incorporate a global health experience into the nursing curriculum. At the University at Buffalo, we were able to utilize the three week winter intercession between fall and spring semester to develop and implement a 2-credit, faculty led global study abroad course. The destination for this global study abroad course has been Belize in 2014 and 2015. This global study abroad course provides students an opportunity to integrate academic study with community engagement. The course fosters the development of cultural sensitivity, civic engagement, advocacy, collaborative practice, ethical decision making, and social responsibility. In 2016, while Belize was still the global study abroad course destination, we collaborated with the University at Buffalo School of Pharmacy, to create an interdisciplinary approach to the study abroad course. Students from both nursing and pharmacy traveled and worked together providing care to the Belizean villagers.
Initially seven students participated in the global study abroad course in 2014, with an increase in student engagement with twelve students participating in 2015. Students included pre-nursing majors, junior and senior nursing students, as well as nursing students from another university. Students were required to complete pre-departure orientation including review of common tropical diseases, their presentation and treatment. To facilitate effective communication with the villagers, students were required to learn some common Spanish words and phrases. To provide a detailed log of their trip experiences, students completed daily journals documenting their daily activities, village home visits, and medical clinics. Upon return to the United States, students completed a written reflection and evaluation, as well as a video compilation of their experience.
Students had a wide range of experiences and knowledge prior to embarking on this journey. They were able to build upon each other’s strengths to increase their own knowledge and skill set. Further, they were responsible for initial triage of the patient, followed by completing a history and physical, reporting their assessments to the physician, and most importantly, providing education to the patient addressing health promotion, medication management, and safety practices in the home. At both villages, students had an opportunity to visit with the school children to provide education on topics such as skin care, oral hygiene, and personal hygiene.
Students were truly immersed in the culture of Belize. Student lodging was at a small missionary camp in one of the local villages where traditional Belizean meals were prepared. Students visited two villages for a total of four days, while completing home visits. Students were encouraged to communicate with the villagers in the villager’s preferred language. They were able to witness the living conditions the villagers experienced on a daily basis.
Students participants also had an opportunity to participate in a few recreational activities where they were able to gain an appreciation for both the history of Belize and its vast tourism which provides the country with an immense amount of economic support. Students had the experience of visiting the University of Belize nursing school where they had the opportunity to speak with a director of the nursing program. Ultimately, students came to appreciate the similarities in their own home nursing program and the University of Belize nursing program. Students were truly immersed in an experiential learning opportunity and gained a true appreciation of the people and culture of Belize.
Analysis of student journals and reflections revealed an overwhelmingly positive response to the global nursing experience. Only one student had any previous study abroad experience, so the remaining eleven students were embarking on this journey for the first time. 100% of the students felt the cross-cultural experience was the best aspect of this global nursing course. As there were very few diagnostic tests available for the residents of Belize, students had to rely solely on their ability to obtain a complete history as well as their astute assessment skills and completion of a thorough physical exam. There were no automated blood pressure cuffs, x-ray machines, or CT scanners to support the delivery of nursing care.
The majority of students had completed only one semester of nursing school, which included their health assessment course, but very limited, if any, time in the hospital clinical setting. After completing this global health course, students felt much more confident in their ability to perform a thorough and accurate history and physical assessment; report pertinent findings to the physician, and provide education to their patients. Students also reported that this course made them feel more comfortable communicating with their patients and physicians. Several students stated they felt less intimidated when having to work with a physician or asking the physician a question. They felt this confidence would carry over when they return to the clinical setting in the United States. In terms of cultural competence, one of the student’s statements “says it all, “There are many cultural differences. I will never learn them all. There are cultural differences within one culture. I don’t have to understand them all, what’s most important is that I respect them.”
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