One strategy to decrease the stress of clinical placement is engaging NP students in global service-learning programs for completion of a portion of clinical hours. Students who participate in global service-learning have the opportunity to gain cultural competency and cultural humility, while often finding themselves in limited-resource settings which require dependence on their history and exam skills and less reliance on laboratory and diagnostic studies. These faculty-led programs can also provide an opportunity for students to engage in international research projects.
Faculty roles identified in global service-learning are initiator, collaborator, facilitator, and advocate (Kohlbry & Daugherty, 2012). The role of advocate is very important for programs focusing on NP students, because the role of the NP is not understood in many parts of the world. NP faculty also find themselves in the role of preceptor in the clinic setting.
Developing a successful faculty-led global service-learning program for NP students requires global collaborations and partnerships. Not only must faculty plan a program that meets learning objectives for students, meeting the needs of the community where the program will occur must be at the forefront. Collaborating with organizations operating within the country that the program will take place can provide a framework for sustainability and follow-up, while easing logistics such as navigating country requirements to obtain authorization to practice. Fostering the right partnership is crucial to success and sustainability of the program. Faculty must consider the mission of the organization and capacity to continue and follow-up on services provided.
Amerson (2014) developed ten research-based recommendations for successful implementation of global service-learning programs for nursing students, which included utilization of a service-learning framework, country selection, collaborating and forming partnerships with local organizations, providing opportunities for hands-on care and involving students in health education teaching. Based on these recommendations, we developed a one week service learning program for family nurse practitioner (FNP) students in partnership with a non-governmental organization (NGO) in Nicaragua. Because Nicaragua continues to have one of the highest cervical cancer mortality rates in Latin America (Capote Negrin, 2015), the focus of our program was cervical cancer screening and education for women in rural areas. Through partnership with a second local NGO, faculty and two FNP students worked with a program already providing cervical cancer screening in partnership with the Nicaragua Ministry of Health.
The program allowed NP students to meet their women’s health clinical requirement and work with faculty on a research project, while assisting the NGOs in meeting needs of the community through cervical cancer screening. Students received 60 clinical hours for the program which is in line with other global service-learning programs at the university and documented by a similar program to Haiti (Byrne, Collins & Martelly, 2014).
Both the NP faculty and students went through the credentialing process for the Nicaraguan Ministry of Health to obtain permission to practice. Over the course of the week, 240 women in three communities in León received cervical cancer screening and health education. The NGO returned to the community once results were received and performed follow-up if required.
Students and faculty also developed a research project to meet the students’ research requirement, which was implemented while in Nicaragua. This required obtaining authorization from the NGOs to conduct surveys during clinic and approval from the university’s international institutional review board (IRB). Women presenting for care were administered a survey to explore perceived barriers to cervical cancer screening. Students and faculty returned to Nicaragua five months later to present the findings to the NGOs and other key stakeholders. While this was the first step in an ongoing research project, the team experienced challenges such as navigating international IRB, language barriers, ensuring local partners understand the research process and maintaining data integrity. These were all valuable lessons in planning and implementing an international project.
While global service-learning programs for undergraduate nursing students are well documented, programs focusing on NP students are not as common. Our experience is that with carefully selected partners, global service-learning is an excellent adjunct to traditional clinical experiences. The purpose of this presentation is to engage novice nursing faculty in a conversation regarding development of global service-learning programs for NP students, the importance of global collaborations to ensure ongoing support to both the educational program and the community served, and suggestions for navigating international research.