The purpose of this abstract is to discuss the evaluation of a global clinical Community Health experience of undergraduate nursing students in one of three countries: Panama, St. Croix or Scotland to more fully evaluate the overall global student experiences and learning outcomes.
Methods: A semi-structured questionnaire was developed by the faculty, and input into Qualtrix survey system to gather data in a reasonably “naturalistic” way using a Grounded Theory methodology (Saks & Allsop 2008). This questionnaire was administered to 47 students from 3 subset global clinical groups who participated in the Community Health clinical course in either St Croix, Panama or Scotland. The Global Experience Questionnaire was adapted from International Education Survey (IES) evaluating readiness, challenges, benefits, professional development, confidence and benefits on future clinical practice. This section of the questionnaire contains 9 questions on a Likert-type scale from 0 (not at all) to 4 (extremely) that evaluated preparation, fears, adequacy of information, challenges, culture, confidence, supervision, personal and future clinical practice benefits. Three additional open-ended questions examined perceptions of different healthcare systems, challenges to nursing practice, and potential impact on future cultural nursing practice.
A thematic analysis identified emerging themes. The faculty team reviewed the survey responses and independently coded them. Following the coding, the team reviewed the themes for agreement and consistency merging the codes into a single codebook. The resulting themes were examined by the project team and consensus was reached regarding interpretations of the data.
Results: 100% of the students responded to the survey.Coding the responses to the semi-structured interview questionnaire resulted in five themes: culturally competent care, access to care, patient interactions, technology and evidence-based practice, and professional interactions. These themes reflect the perceptions of students regarding health care systems, nursing practice challenges, and culturally and linguistically appropriate care.Student responses revealed that they felt adequately prepared for the cultural experience and had appropriate skill attainment. Overall, the students expressed satisfaction with the clinical experience and felt the experience shaped them positively as nursing professionals. However, Spanish language posed barriers for some students, and constant translation needs wearied the students who had Spanish as a first language. Additionally, socioeconomic issues such as severe poverty, and issues of alcohol abuse were new experiences for some students, and will require additional preparation in future.
Conclusion: The adapted Global Experience Questionnaire provided useful information to assist the faculty with future student pre-departure preparation development and captured the dimensions of global clinical practice, barriers and professional benefits. Undergraduate nursing students enrolled in a /Public Health Nursing course were exposed to a variety of professional nursing and health care delivery models during this international clinical immersion experience.These in-depth experiences necessitated the need to adapt to cultural and language differences. Students articulated an altered perspective of their view of global health and healthcare delivery giving them the opportunity to understand other healthcare systems. Students who journeyed to Panama and St Croix articulated challenges related to limited resources and poor healthcare infrastructure when compared with the US healthcare system. However, students felt empowered by this and reflected on how they would be willing to return to those locations and expressed a desire for a career that included global nursing.