Making a Difference: Changing Nursing Students' Global Beliefs

Thursday, 19 July 2018: 3:30 PM

Christine Ann Argenbright, PhD1
Julie Sanford, DNS, MSN, RN1
Vesna Hart, PsyD2
Portia Jordan, PhD3
Mariette Bengtsson, PhD4
Michiko Moriyama, PhD, RN5
Maria Jimenez Herrera, PhD6
Gwen Sherwood, PhD, RN, FAAN7
Lee Peng Lui, PGCLTH, Msc8
Yum Iwamoto, MA9
(1)School of Nursing, James Madison University, Harrisonburg, VA, USA
(2)Global Engagement, James Madison University, Harrisonburg, VA, USA
(3)Department of Nursing Science, Nelson Mandela University, South Africa, Port Elizabeth, South Africa
(4)Nursing, Malmö University, Sweden, Malmö University SE 205 06, Sweden
(5)Division of Nursing Science Graduate School of Health Sciences, Hiroshima University, Hirosima, Japan
(6)Nursing, Universitat Rovira i Virgili, 43002 Tarragona, Spain
(7)School of Nursing, University of North Carolina, Chapel Hill, Chapel hill, NC, USA
(8)Faculty of Health, Joint Faculty, Kingston University and St George's University of London, London, United Kingdom
(9)Hiroshima Bunka Gakuen University, Kure-city, Hiroshima, Japan

Purpose: In August of 2017, the Nursing Leadership Collaborative of the International Network of Universities (INU), convened in Hiroshima, Japan to hold a patient safety and quality of care workshop for nursing students from six INU universities located in Japan, Spain, Sweden, South Africa, United Kingdom and the United States. The workshop, held during Peace Week, had as its purpose to develop a model of international collaboration and education to impact quality and safety education in nursing. In addition to examining the impact of the experience on student learning, the leaders wished to determine to what degree students’ beliefs and values changed due to participation in the nursing collaborative workshop. The purpose of this research was to measure students’ self-reported beliefs that reflect global competency and openness to cultural diversity.

Methods: IRB approval was obtained and a pre-post-test mixed method design was used with the convenience sample of 21 English speaking international undergraduate and graduate nursing students. The workshop lasted 9 days and included a curriculum based on the Quality and Safety Education for Nurses (QSEN) Competencies. Experiential clinical activities focused on how patient safety is improved in Japan. Cultural activities were integrated and primarily focused on the Peace Week events which included the Peace Day ceremony to memorialize the dropping of the atomic bomb on Hiroshima. The Beliefs, Events, and Values Inventory (BEVI), a mixed methods measure, was administered and used to asses relevant processes and constructs including (but not limited to); "openness; receptivity to different cultures; stereotyping; self and emotional awareness; and strategies for making sense of why people do what they do." (Shealy, 2005, p. 99). This study examines Time 1 (prior to participation in the program) and Time 2 (immediately after the completion of the program). Students also completed daily reflections in response to prompts provided by faculty. Qualitative data analysis was completed using NVivo software.

Results: Results from the group aggregate data analysis indicate that prior to the start of the program (Time 1) this group presents itself as quite introspective (Self-awareness = 75thpercentile); midway between confident and inquisitive in terms of understanding who others are, how world works, and their experience of life (Basic Determinism = 41st percentile); quite open to and interested in cultural beliefs and practices that are different from one’s own (Sociocultural Openness = 74th percentile); open to non-traditional gender roles (Gender Traditionalism = 20th percentile); do not have strong religious convictions (Religious Traditionalism = 26th percentile); and express a high degree of concern about ecological issues and the natural world (Ecological Resonance = 59th percentile).

Following the completion of the program (Time 2), the group as a whole reported being more sophisticated in making causal explanations about why the world works in the way it does (Basic Determinism = 30th percentile); increased openness to and interest in cultural beliefs and practices that are different from one’s own (Sociocultural Openness = 80th percentile); increased openness to non-traditional gender roles (Gender Traditionalism = 13th percentile); further decrease in strong religious convictions (Religious Traditionalism = 20th percentile); and increased degree of concern about ecological issues and the natural world (Ecological Resonance = 71stpercentile). On the other hand, results on two scales show decreased Self-Awareness (Time 1 = 75th percentile; Time 2 = 62nd percentile) and Emotional Attunement (Time 1 = 50th percentile; Time 2 = 43rd percentile) at the end of the program. Such results are common immediately following an intensive global learning experience, and the longitudinal assessment indicate that human beings exposed to experiences that are highly discrepant from their usual experiences may need time to consolidate the learning, growth, and development that occurs (Hart et al, 2015; Shealy, 2016). Statements from qualitative data analysis reflect greater understanding and empathy for others’ perspectives and experiences and increased openness.

Conclusion: Nursing students experienced changes in their beliefs and values that reflect a greater degree of global competency after the short term international workshop experience with other nursing students.