Methods: The instrument for this exploratory, descriptive study was developed by the researcher and administered online using Qualtrics® after approval by the university’s institutional review board. Participants were recruited through a survey link emailed to approximately 1600 deans or directors of accredited US nursing schools, who were asked to forward it to faculty who oversee SLEs. Frequencies were tabulated using SPSS (v.24).
Results: The sample consisted of 77 nursing faculty from 32 US states who provided complete data (58% of the 133 who opened the link). Respondents were primarily female (97%), white (86%), and over the age of 50 (72%). Most faculty (75%) were affiliated with BSN programs and accompanied the students to the SLE (47% for the entire time, 31% part of the time). Twenty-three percent of the SLEs were located outside of the US with the majority of those being in the Caribbean, South America, or Central America; 55% were in local communities and 18% were within commuting distance. Academic credit was conferred for 61% of the SLEs. For 55% of the SLEs, students incurred no cost, although some required that students to pay for transportation (33%), meals (16%), lodging (12%) and/or a program fee (16%). The table summarizes selected recommended practices (Amerson, 2014) and gives results for related survey items.
|
Recommended practice |
Selected survey results (% of total n=77) |
|
Choice of location should be tailored to course content. |
-96% say it is extremely or somewhat important that the service provided by students be coupled with course content. -most student participants are enrolled in a required (73%) or elective (23%) course. |
|
Preparation should include discussion of sociocultural aspects of the host community. |
-preparation includes experiences at home that give insight into host culture (42%). -preparation topics include (to a great or moderate extent): host healthcare systems (84%), health disparities (81%), cultural norms (80%), economic disparities (78%); cultural humility (72%); stereotyping (75%); local customs/foods (70%); privilege (68%); racism (69%); cultural arrogance/sense of superiority (67%); religious beliefs of hosts (55%); poverty tourism (51%). |
|
Experience should push students out of comfort zone; expect student anxiety and ambivalence about their own resources. |
94% say it is extremely or somewhat important that the experience take students out of their “comfort zone.” -reflection sessions address: personal transformation or growth (95%), inequities in resources and opportunities in the host community (95%). |
|
Experiential learning, especially home visits, are the best way to understand real life in the host community and develop cultural competence. |
-activities onsite: nursing assessment or care of clients in homecare setting (48%); nursing care of clients in a clinic-type setting (48%). |
|
Partnering with organizations in the host community sustains relationships and helps address their true needs. |
-96% say it is extremely or somewhat important that efforts are made to build long-term, sustainable partnerships that address the needs of the host community -69% say that the host community believes the service provided by the students addresses the needs of the host community to a great extent. -34% say that the planning phase includes asking members of the host community how needs can best be served |
|
Unstructured time promotes learning about culture and improves communication. |
-activities onsite: talk informally with people from the host community (70%); interact/play with children (60%); share meals with people from host community (53%); unstructured time for students (42%) |
|
Students should teach people in the community and learn foreign language when necessary. |
-students required to: develop some degree of foreign language competency (4%); complete teaching project for individuals and groups in the host community (70%) |
|
Journaling/blogging/photography promote reflection and self-evaluation. |
-required assignment such as photo journal, blog, interview: onsite (57%), after return (53%).
|
Conclusion: Overall, faculty involved with SLEs adhere to recommended practices. SLEs are usually coupled with course content so students likely benefit from cohesive, integrated, experiential learning. Sociocultural issues that affect the host community and potential pitfalls of SLEs are discussed by the majority of faculty in the preparation phase. Despite the anxiety and ambivalence SLEs may cause, faculty overwhelmingly agree that SLEs should take students out of their comfort zone. Journaling and similar strategies allow for reflection and self-evaluation either onsite or after return.
Some SLE leaders should consider increasing the amount of unstructured time for students to interact with people in the host community. Leaders should plan experiences that give students a first-hand glimpse into host culture prior to the SLE. Opportunities for home care experiences should also be explored. Schools that do not require teaching projects should consider adding those. Developing partnerships with organizations in the host community to ensure meeting their true needs is viewed as important by a strong majority, although only 69% say that the host community believes the service provided addresses their needs to a great extent. Balancing the needs of the community with the learning needs of the students is a persistent challenge to service learning.
Reference:
Amerson, R. (2014). Research-based recommendations for implemeting international service–learning. Journal of Professional Nursing, 30 (2), 175–179.