Cultural Humility and Nursing Education for Study Abroad Nursing Students

Sunday, 30 July 2017

Dalit Wilhelm, MA, RN
Cheryl Zlotnick, DrPH, MPH, MS, RN
Cheryl Spencer Department of Nursing, University of Haifa, Mt Carmel, Haifa, Israel


 Bachelor’s nursing students in a study abroad program are plunged in a different society, with a different culture, language, and orientation. Universities repeatedly note the importance of transcultural nursing experiences that study abroad programs can provide. These programs often report broadening perspectives and bringing awareness to the lack of cultural humility. Ethnocentrism influences our ability to absorb and learn about cultures, and determines how we filter information (“environmental sensitivity”), why we focus on an observation, and what we think about the experience. Thus, lack of cultural humility influences our learning. Educators are challenged to address this problem in study abroad nursing students by finding methods and processes to help them acclimate, learn, and function as student nurses. This project describes a program designed to make ethnocentrism visible and enable students to access their biases.


 Norwegian nursing students come to Israel for a semester-long, study abroad program in Israel. The program provides a two-facet strategy to enable them to view their perspectives on population behaviors and health care services: (1) theoretical learning; and (2) clinical practice. Within the theoretical course, students learn about the basics of cultural humility. They receive a framework on how to self-examine their own perspective of their and other’s culture (Hays’ ADDRESSING MODEL), have the opportunity to an exercise (theater) to practice the model, and to implement these principles in “real-life” situations within clinical practice.


 Nursing students are challenged by their experiences in clinical practice. The students write about their internal discussions between what they believed at the outset and how those beliefs have been reframed. The cycle and process of these newly evolving beliefs demonstrate the ability of nursing students to make better understand the impact of having a set of cultural beliefs, and projecting these beliefs on others. They describe surprising themselves with their former rigid thinking, and feeling less judgmental and having more flexible thinking as a result.


Although this program is useful in a study abroad program where the vast different cultures are emphasized, this program would be useful in all nursing programs where students encounter patients who are different from them in Age, Development/Disability, Religion, Ethnicity, Sex, Socioeconomic, Immigration/Indigenous, Nation, Gender (ADDRESSING). This process allows students working with individuals of different cultures to create their own internal language that facilitates their evolution - to make the invisible, more visible and - to become transculturally aware professionals.