Advancing Global Health Outcomes Through International Collaboration and Education

Saturday, 21 July 2018

Olivia Catolico, PhD, RN, CNL, BC1
Leandra Wallace, DNP, RN, FNP-BC, PHN1
Jane Anyango, MSN, RN2
Kathrina Bell, EdD3
(1)Department of Nursing, School of Health and Natural Sciences, Dominican University of California, San Rafael, CA, USA
(2)Uganda School of Nursing Bwindi, Kanungu, Uganda
(3)Global Education Office, Dominican University of California, San Rafael, CA, USA


This presentation highlights an effective educational process that promotes global health outcomes through an international collaborative and educational partnership. At the end of this presentation the conference participant will be able to:

  • Recognize the importance of mission driven values in fostering cultural sensitivity, appreciation of diversity, and respect for others;
  • Describe evidence based interventions that promote intercultural understanding in the teaching-learning process that includes multiple world views, experiences, and power structures;
  • Facilitate student understanding, through comparison and contrast of healthcare delivery systems, and the roles of health professionals and community liaisons in health promotion and illness prevention;
  • Discuss evaluative activities that intentionally facilitate students’ personal reflection and professional growth through collaborative participation in cultural immersion.


The advantages of cultural immersion experiences or study abroad opportunities for students are documented in the literature (Phillips, Bloom, Gainey, & Chiocca, 2017; Stone, Duerden, Duffy, Hill, & Witesman, 2017). While these opportunities are readily integrated into study programs in higher education, they may present curricular challenges for professional programs that are legislatively regulated by state and national accreditation bodies. Nonetheless, mission-driven values at the broader institutional level facilitate implementation of these learning opportunities.

The nursing faculty at Dominican University participated in previous medical missions to Uganda over several years. Through the establishment of educational and community networks, and relationship building, the Dominican nursing faculty, and the Director, Uganda School of Nursing, Bwindi (USNB) embarked on an undergraduate level course, “Global Health Nursing and Healthcare: Bwindi, Uganda”.

Conceptual definitions that guided the development of the course and learning experiences were those of the Global Advisory Panel on the Future of Nursing (GAPFON), (Wilson, et al, 2016). Additionally, the missions of Dominican University and the Uganda School of Nursing, Bwindi articulated like values.

The Bwindi region faces many challenges including access to healthcare, economic, and material resources, which may vary widely within Uganda. Malnutrition, food and water safety, sanitation and hygiene concerns, illness and infectious diseases across the lifespan are widespread issues (Braveman, 2014; Skolnik, 2016a; Skolnik, 2016b; Skolnik, 2016c). Many areas surrounding Bwindi rely on village health teams (VHT) who travel to reach outlying villages for care and treatment. They provide immunizations, health assessments, dental care, HIV/AIDS screening and medications (Mays, O’Neil, Mworozi, Lough, Tabb, Whitlock, Mutimba,…Talib, 2017). Through the work of several philanthropies, there is now a Bwindi hospital, clinic, emergency room, and school of nursing to support the community.

Teaching Methodology

Orientation sessions with assigned readings were scheduled with Dominican students prior to travel to familiarize students with historical, cultural, socio-economic, and political factors in the region of Bwindi. Student expectations included utilization of cross-cultural knowledge and culturally sensitive skills in implementing care to individuals and families, or in implementing community based interventions. Dominican students were also introduced to the United Nations Sustainable Development Goals (UN, 2017). Once abroad, frequent informal meetings took place between Dominican faculty and the Director, USNB, to coordinate learning activities among students of both schools, to discuss unanticipated issues as they arose, and to implement contingency plans for learning as needed.

Pedagogy included active engagement with village health teams in providing health assessment, HIV/AIDS education and prevention to the local schools, collaborative “windscreen assessments” and home visits to the community for the purposes of planning and intervention. Under the supervision and guidance of faculty of both schools, the USNB Director, and hospital staff, Dominican and USNB students rotated in pairs through various areas of the hospital and clinic. Community discussions, people-to-people interactions, observations, and debriefings were ongoing activities. Faculty-led debriefings from both schools were a vital part of helping students examine other perspectives, systems, and roles within context of culture.


An evaluation involving students and faculty of both schools took place at the end of the experience. For the purposes of academic credit, visiting students to Bwindi submitted written assignments to faculty which consisted of the following:

  1. Reflective journals, which the faculty read, and provided written commentary.
  2. A collaborative plan of care developed jointly with students of both schools using the “windscreen assessments”.
  3. An integrative paper utilizing the literature, experience, and observation, that focused upon a health-related sustainable development goal.


Overall, students expressed appreciation and value for this high impact learning experience which has informed their worldviews. Ongoing communication, and advanced planning among participating entities is vital to ensure mutually relevant teaching-learning opportunities, and logistical coordination of personnel and resources for both the host and visitors.

Implications for future programs include identifying ways and means to sustain collaborative study abroad partnerships. Also important is the need to sustain quality education whereby all parties reap mutual benefits of intercultural exchange, while helping families and communities move forward toward improved health outcomes.

As study abroad and cultural immersion programs continue to grow, it is important to develop effective measures to determine the long term impacts such programs have upon families and communities in the host country, and upon student learning, professional practice, and education.