Just go For it”:-Student and Staff Evaluative Reflections of a Global Learning ...€¦ · · 2017-10-10perspectives of facilitating such experiences and students ... • To broaden

Cardiff School of Healthcare Sciences Ysgol Gwyddorau Gofal Iechyd

“Just go For it”:-Student and Staff

Evaluative Reflections of a Global Learning Opportunity-POLO

Beverley Johnson

[email protected]


Today’s Presentation Aim

To explore evaluations of global learning experiences: - staff perspectives of facilitating such experiences and students reflective accounts. Outcomes

• Outline the reflective evaluations of students global learning opportunities;

• Discuss the value and challenges from both staff and a student perspective and

• Discuss and reflect on such evaluations applied to personal practice.

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Background

• Increasing trend for nursing students to undertake placements abroad

• Such placements offer valuable experiential opportunities to develop personal growth and global culturally sensitive nursing skills

• Benefits and challenges exist

• The use of short placements abroad (e.g. POLO) presents a valid source of global learning to complement traditional home placements.

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Global Health

• ….”improving health and achieving equity in health for all people worldwide. Global health emphasises transnational health issues. determinants and solutions……synthesis of population based prevention with individual level clinical care (Koplan et al 2009:1995)

Cultural Competence

• …”Ongoing process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of the client ( family, community). An ongoing process that involves integration of cultural awareness, knowledge, skill, encounters and desire (Campinha- Bacote 2002:181)

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POLO:- Practice Optional Learning Opportunity

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What How

When

Why

Where


• Objectives:

• To broaden the student’s knowledge and understanding of the provision of healthcare to a diverse group of people and critically discuss differences delivered outside the usual practice learning opportunity partners in South East Wales;

• To reflect on issues pertinent to the provision of culturally sensitive nursing care

Year 2, PLO 4,

What When


• Previous overseas opportunity followed the 13 week Erasmus placement

• Inflexible, undersubscribed

• Needed a more student friendly overseas opportunity – POLO developed

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Why


We developed :- •New European and further afield partnerships made,

building on School’s existing ones •Audited all fields •Health and safety tripartite risk process/forms etc. • School Scholarship scheme •Administrative procedures and processes put in place e.g.

Student/staff handbook •Administrative support- key

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How


International

Student Exchange Partnerships

• Sweden-Linkoping,

Gothenburg & Lund,

• Finland-Tampere,

• Namibia*

• Malta

• Oman

9/12/2017 9

Where

Independently Organised

Malawi, Tanzania, Botswana, Ghana, Uganda, Zimbabwe, South Africa, Ireland, India, Australia, Hong Kong, Thailand Philippines, El Salvador, Cambodia, Quatar, Dubai, Guatemala, Japan New Zealand, Sri Lanka……….


Reflection Template

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• What did you anticipate that you would learn from your

experience that could broaden your knowledge and

understanding of global health care?

• What were your highs?

• What did you find challenging?

• How did you overcome your challenges?

• How did the delivery of healthcare you were exposed to

differ/compare from that provided in the UK?

• What have you gained both personally and professionally

that you will apply to your future practice?

• Any top tips for other students?


Student reflective accounts: Data collection

• On immediate return from POLO first theory block

• Convenience but representative sample

• Collated the accounts utilising the template headings

• Then applied thematic analysis

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Components of Cultural Competence

.

Cultural Awareness

Cultural Knowledge

Cultural Skill

Cultural Encounter

Cultural Desire

Campinha- Bacote, (2002)


Cultural Awareness

Cultural Competence Core Component

Main theme Sub-themes

Cultural Awareness

Compassion Observations in developed countries

Observations in underdeveloped countries

Connections

Different to UK. Learnt the lengths that they go to, to care for their population (Finland). E.g. Access to healthcare in remote regions Excellent rapport patient/ nurses Welcoming to strangers

Compassion not overt due to differing standards. Yet patients grateful Staff lacked compassion Family care

The heart, of a healing environment, regardless of language/culture. Integral to nursing. “I never realised how far compassion goes it means everything to patients and their care”. Fortunate to be human and feel human. Compassion power/ knows no boundaries Compassion/care/warmth can always be shown by NVC. Compassion is global Dignified care doesn’t cost LITTLE THINGS MAKE A BIG DIFFERENCE Increased empathy Difficulty of respecting cultural norms

Culture shock

Immersion in a “foreign” culture somewhat similar to their own still able to identify differences and experienced degree of culture shock

Still seemed in shock

Off balance Adjustment Coping Openness Problem solving acceptance

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Cultural Knowledge



Cultural Knowledge

Professional/ Learning

Evidence Based Practice Nurse patient relationships Family centred care Ethical dilemmas-Patient participation/autonomy/Patient safety/ pain management Equity/social justice/advocacy/dignity Value of their education/in NHS Global practices Economic political influences

Personal growth

Confidence assertiveness Self-belief, courage, self-reliance tolerance flexibility adaption-resilience Moral courage & courage to teach Recognition of knowledge Transferable skills

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Cultural Skill, Encounter and Desire



Cultural Skill Empathy Respect versus prejudice Communicat

ion Therapeutic relationships have no language Diplomacy

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Cultural Encounter

Profound Varying degrees- life changing – no going back (shame/guilt)

Increased world view

Realised world outside of theirs Cultural humility

Cultural Desire Motivation Passion Desire to learn more about themselves and others


Findings- Broader relevance

• Range and content of reflective accounts

– reflect NMC (2010) years 1 & 2 progression criteria

– 6Cs (Cummings & Bennett 2012 A & B)

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Care – valuing patients/ putting them first

Compassion – never forget fundamental values, dignity, respect, non judgemental Competence – Challenged care, developed independence, set up clinics. EBP, recognised existing knowledge

Communication – Language, NVC universal, confidence in questioning Courage - to go abroad sometimes alone, to move out of comfort zone, recognition of individual strength, tenacity. Commitment – to improve care, to fundamental values, to stay when there are multiple challenges.


Challenges/strategies to overcome challenges

• Professional – overcoming professional differences

• Emotional- re-adjustment guilt student support/well-being module, new handout

• Language Barriers- Languages for All

• Social- loneliness, lack of social media

• Academic- alteration to structure and theoretical assessment

• Practical

• Financial- fundraising, application for grants

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Strategies to overcome challenges

• Information prior to during and after-

• Pre-departure checklist, online study resource, previous student experiences, contacts, buddy with incoming students, Mobility Fairs, Global Healthcare Symposium/Conference

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Our Initial reflection POLO Objectives:

• To broaden the student’s knowledge and understanding of the provision of healthcare to a diverse group of people and critically discuss differences delivered outside the usual practice learning opportunity partners in South East Wales;

• To reflect on issues pertinent to the provision of culturally sensitive nursing care

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Limitations

• Reflection limited to immediate learning

• Limited application to practice

• Student choice

• Challenges of reflection and the tool

• 5 cohorts in 1 university team/evaluation

• Ethical challenges

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Conclusion: “Just Go for it” • Short placements abroad offer immersion with

unfamiliar learning environments that provide profound powerful opportunities for significant professional and personal rewards

• Outcomes achieved- global health/cultural competence as well as NMC (2010) standards

• Utility of evidence- breadth and diversity, not restricted to specific student group/practice setting

• Practical, academic, clinical and pastoral support is required, for such benefits to be achieved :- – prior to – whilst abroad – identified on evaluation and followed up on return

• Not as simple as “Just Go For It”

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Future recommendations

• Refine and evaluate the reflective exercise- Focus groups

• Compare and contrast 3rd year reflective accounts- immediate and longer term learning

• Submit a Research proposal

• Dissemination: – Publication

– Feedback to nursing and other healthcare science students

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Thank you

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References • Campinha- Bacote, J.(2002). The Process of Cultural competence in

the delivery of healthcare Services: a model of care. Journal of Transcultural Nursing , 13, 181-84

• Cummings J, Bennett V (2012a) Compassion in Practice: Nursing, Midwifery and Care Staff. Our Vision and Strategy. http://tinyurl.com/c5lc4n2 (accessed 6 July 2016)

• Cummings J, Bennett V (2012b) Developing the Culture of Compassionate Care.[Consultation Paper] DoH, London

• Koplan, J.P., Bond, T.C. Mersen, MH, Reddy, K.S., Rodrigueuez, M.H., Sewankambo, N.K., & Wasserheit, J.N. (2009) Toward a common definition of global health. The Lancet, 373, 1993-1995

• NMC Nursing and Midwifery Council (2010) Standards for pre-registration nursing education. NMC, London

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“Just go For it”:-Student and Staff

Evaluative Reflections of a Global Learning Opportunity-POLO

Beverley Johnson and Dawn James

[email protected] [email protected]

mailto:[email protected]

mailto:[email protected]

Documents

Just go For it”:-Student and Staff Evaluative Reflections of a Global Learning ...€¦ · · 2017-10-10perspectives of facilitating such experiences and students ... • To broaden