As the largest group of healthcare providers nurses need to be prepared to be leaders in the delivery of global health in an interconnected world. This group of professionals is poised to offer leadership in facilitating solutions for global health problems. The basis for learning about global health begins with awareness and exploration of global health issues in the program of nursing. Educational programs that prepare students for the profession of nursing must include strategies that develop behaviors that enable engagement, community contributions, inter-professional dialogue, and practice-based learning (Guerrin, 2014). These types of programs have been correlated with increased cultural competence and understanding of national health problems (Brown, 2014).
There are challenges to the integration of global health in nursing curriculums. Already nursing programs are heavily laden with content, and it might be problematic to find qualified faculty and funding for strategies that could involve travel (Turale, 2015).. However, there has been increased recognition and attention to the need for global health nursing education. The American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education for Professional Nursing Practice identified global health care as an area of core knowledge for nursing practice (AACN, 2008). According to Clark, Raffray, Hendricks, and Gagnon (2016) nurse educators are in need of guidance in regards to the development and integration of global health concepts into the curricula
Using the United Nations Sustainable Developmental Goals (2015) as a guide, as well as current literature on global health, a test was developed by the researchers to ascertain knowledge of global health. A twenty-five item closed-ended test was created covering health issues related to disasters, contagious diseases, war, access, and poverty. Following the questions on global health issues respondents were also asked demographic information and if they had studied abroad in the past. Finally they were asked to rate the exposure they had experienced in nursing school with respect to global health.
After securing IBR approval, a non-probability sample was generated by face-to-face administration of the test to BSN nursing students at two universities (one public and one private). An online administration of the test was also given to a group of RN-BSN students. The final sample consisted of 53 junior nursing students, 46 senior nursing students and 38 RN-BSN students for a total of 137 participants.
To score the ten-item test, the numbers of correct answers per test were tallied. The range of scores was quite wide varying from 1 to 10, however the average score for the entire sample was 6.7 items correct. Although the RN-BSN students as a group scored slightly better than the traditional students, (7.6 compared to 5.8), the average of all student groups fell into the “moderate knowledge” category. The majority of respondents (56%) indicated that there was very little attention to global health during nursing school. Seven percent indicated that this material was not covered at all.
This study sought to discover the knowledge of student nurses with respect to global health. Because this awareness is critical to develop health care professionals who are leaders in global health, it follows that educators might be encouraged to introduce global health into the nursing curriculum in a formal way. The National League for Nursing has, in fact, released a vision for expanding US nursing education for global health engagement with a call to action by nursing administrative leaders and faculty (www.nln.org/about/position-statements/nln-living-documents).
There are many creative ways to increase the exposure of nursing students to global health, ranging from integrating relevant information into academic courses that are already taught, organizing study abroad experiences, development of certificate programs, partnerships with community agencies and international universities, to free-standing courses in global health. Student exchanges with other countries or clinical experiences involving cultural immersion could work in some academic settings. Which is chosen depends on the philosophical framework of the program and resources. For example, if it’s possible to implement a global service-learning program, this may serve to promote global health awareness in students and cultivate an interest in global health leadership.
There were limitations to this study. It was descriptive in nature, so causation cannot be assumed. The sample is non-random and subjects come from only one US state so generalization is limited. However, it encourages consideration of the potential need for more focused and comprehensive exposure of student nurses to global health in their professional preparatory programs. Nurses must be prepared to provide leadership in a global society, and basic understanding of global health is fundamental. Programs should consider ways to introduce and reinforce global health concepts in a way that fits their curricula.