Reported outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education: A narrative systematic review.

OBJECTIVE: To identify outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education. DESIGN: A systematic review of the literature was conducted in keeping with JBI methods. DATA SOURCES: A range of databases were searched, including Medline, Embase, ERIC, CINAHL, ProQuest Central and DOAJ. Studies published in English from 2010 to 2020 were considered. STUDY ELIGIBILITY CRITERIA: The review included qualitative and quantitative primary peer-reviewed research studies involving nursing or midwifery students who participated in international educational programs in their pre-registration education. REVIEW METHODS: Thematic analysis informed by Braun and Clarke was used to identify key outcomes emerging. RESULTS: 56 studies were included. The results highlight similarities in outcomes for students who had undertaken international educational programs in three thematic areas: Cultural learning, Personal growth, and Professional development. Short-term outcomes are well documented, however there is a lack of research investigating long-term outcomes. CONCLUSIONS: Further research is required to investigate long-term outcomes of international educational programs and means for measuring the effects on students' future professional practice. In addition, further research is needed to explore the perspectives of, and impact on, others including host communities and universities, and other stakeholders.

"We Learn and Teach Each Other": Interactive Training for Cross-Cultural Trauma-Informed Care in the Refugee Community.

This paper introduces culturally responsive and trauma-informed mental health training modules to build and enhance competences and partnerships among mental health professionals and refugee community leaders, while facilitating intercultural, mutual learning between participants from various cultural and professional backgrounds. Focus group interviews and participant self-reflections with the training participants (N = 54) were analyzed using thematic analysis. Findings revealed an enhanced understanding of culturally unique as well as universal trauma responses and coping in the refugee community, which led to the building and strengthening of a sense of community and an expansion of social networks and support systems. This study highlights the effectiveness of interactive learning and knowledge transference among participants with various cultural and professional backgrounds, showing that face-to-face interactions and mutual learning reportedly facilitated building relationships and trust among participants and especially those between refugee/immigrant community leaders and service providers.

Cultural diversity approaches in schools and adolescents' willingness to support refugee youth.

BACKGROUND: Culturally diverse schools contribute to adolescents' intergroup relations. Complex and inclusive social identities are mechanisms that can explain the link between structural school cultural diversity (i.e., proportion of students of immigrant descent and the number of different ethnic groups) and positive intergroup relations. We expected that similar mechanisms might be at play linking cultural diversity approaches in schools with adolescents' intergroup relations. AIM: We examined the link between two sub-dimensions of cultural diversity approaches (i.e., equal treatment; heritage and intercultural learning) and adolescents' prosocial intentions and behaviour towards refugee youth. Then, we explored the mediating role of identity inclusiveness (i.e., perceived similarity of the self with others). SAMPLE AND METHODS: We sampled culturally diverse eighth grade adolescents from 54 classrooms in Berlin (N = 503, Mage = 13.76 years, 50.6% female). Surveys measured perceived cultural diversity norms, adolescents' perceived identity inclusiveness with refugee youth, prosocial intentions to support refugee youth, and willingness to donate to a project for refugee youth. RESULTS: Multilevel models revealed that adolescents' perception of heritage and intercultural learning predicted adolescents' prosocial intentions towards refugee youth, but not their willingness to donate. Equal treatment was not a significant predictor of adolescents' prosocial intentions towards refugee youth, or their willingness to donate. Identity inclusiveness did not mediate the relation between cultural diversity approaches and prosocial intentions. However, identity inclusiveness did positively relate adolescents' prosocial intentions and willingness to donate. CONCLUSIONS: We conclude that culturally diverse schools that engage in heritage and intercultural learning might help to promote positive relations between local and refugee youth in schools and society. Fostering inclusive identities may enhance local adolescent's prosocial intention and behaviour.

COVID-19: A Cross-Sectional Study of Healthcare Students' Perceptions of Life during the Pandemic in the United States and Brazil.

Societal influences, such as beliefs and behaviors, and their increasing complexity add to the challenges of interactivity promoted by globalization. This study was developed during a virtual global educational exchange experience and designed for research and educational purposes to assess personal social and cultural risk factors for students' COVID-19 personal prevention behavior and perceptions about life during the pandemic, and to inform future educational efforts in intercultural learning for healthcare students. We designed and implemented a cross-sectional anonymous online survey intended to assess social and cultural risk factors for COVID-19 personal prevention behavior and students' perceptions about life during the pandemic in public health and healthcare students in two public universities (United States n = 53; Brazil n = 55). Statistically significant differences existed between the United States and Brazil students in degree type, employment, risk behavior, personal prevention procedures, sanitization perceptions, and views of governmental policies. Cultural and social differences, risk messaging, and lifestyle factors may contribute to disparities in perceptions and behaviors of students around the novel infectious disease, with implications for future global infectious disease control.

Integration of Intercultural Learning into an International Advanced Pharmacy Practice Experience in London, England.

As the number of international advanced pharmacy practice experiences (APPEs) continues to grow, this is an opportunity to incorporate intercultural learning (ICL) to further advance student pharmacist training. Purdue University student pharmacists participated in a clinical research focused APPE in London, England. To prepare for this APPE, students completed a one-credit course focused on intercultural learning and travel preparation. The purpose of this report is to describe the implementation and assessment of ICL during this course and international APPE. The course includes interactive ICL activities, reflective assignments, and personalized assessments. During the eight-week APPE, student pharmacists worked on an individualized Intercultural Development Plan®, which includes ICL activities, focused reflection, and check-ins. ICL was assessed using the Intercultural Development Inventory® (IDI®) at the beginning of the course and at least four weeks after APPE completion. Student APPE feedback was also reviewed for evidence of ICL. Twenty-seven students completed the course and APPE from 2018 to 2020. The average IDI developmental orientation (DO) before the course was 91.7, placing students in minimization. The average perceived orientation was 120.9, placing students in acceptance. There were 18 students who completed the post-APPE IDI: 12 students demonstrated growth in the DO (range: 1.5-23.72), and six students experienced a decrease in their DO. Intercultural learning can be implemented and assessed as part of an international APPE.

Maximising intercultural learning opportunities: learning with, from and about students from different cultures.

Nurses continue to experience challenges when caring for culturally diverse patients and while working with staff from different cultural, ethnic and linguistic backgrounds. The widening landscape of cultural diversity in the nursing classroom provides a vehicle for intercultural learning, supporting intercultural competence development. However, students must embrace culturally diverse learning environments and maximise opportunities to learn with, from and about students from different cultural backgrounds. This requires developing the courage, curiosity and commitment to maximise all intercultural learning opportunities. Drawing on experiences of international students studying in culturally diverse classrooms, this article presents some practical suggestions for meaningfully engaging and capitalising on intercultural learning opportunities.

Crítica al Diseño Universal de Aprendizajes: reflexiones desde territorios interculturales locales / Criticism of Universal Learning Design: reflections from local intercultural territories

Este artículo desarrolla una aproximación crítica al enfoque metodológico didáctico que subyace al Diseño Universal de Aprendizaje (DUA) surgido desde el campo de la neurociencia clínica en Estados Unidos de América. Para ello se discute conceptualmente la categoría "universal" confrontada con la idea de "territorio local" mediado por el aprendizaje. El DUA parte de la premisa que toda la población estudiantil es capaz de aprender cuando se toma en cuenta la diversidad en el aula, previa construcción de uncurrículo flexible en su mediación pedagógica para que así realmente se logre el cometido de la inclusión. No obstante, en sistemas educativos centralizados como es el caso chileno, no solo hay riesgos de viabilidad, sino también, de asumir modelos exógenos con sutilezas colonialistas no visibles desde un análisis meramente técnico y de carácter instrumental.

This article develops a critical approach to the didactic methodological approach that underlies the Universal Desing for learning that emerged from the field of clinical neuroscience in the United States of America. For this, the "universal" category confronted with the idea of "local territory" mediated by learning is conceptually discussed. The DUA starts from the premise that the entire student population is capable of learning when diversity in the classroom is taken into account, after the construction of a flexible curriculum in its pedagogical mediation so that the mission of inclusion is really achieved. However, in centralized educational systems such as the Chilean case, there are not only risks of viability, but also, of assuming exogenous models with colonial subtleties not visible from a merely technical and instrumental analysis.

Juggling to survive: Master of Science postgraduate nursing students' experiences of studying far from home.

BACKGROUND: Globally, government and higher education institutions are expected to increase international student numbers. Programme development, marketing international collaboration and management has been the focus of strategy roll out. AIMS: This study aimed to explore international student experiences while undertaking Master of Science postgraduate education far from home. METHODS: A qualitative descriptive design was used. Following ethical approval, 11 students studying on a Master of Science Nursing postgraduate programme in one health education institute in Ireland volunteered to participate. Students were of Asian origin and mixed gender and the average age was 27. Data were collected using face-to-face semi-structured interviews and data analysis followed Burnard's thematic framework. RESULTS: The data provide evidence of the complexities and challenges experienced when studying on a Master of Science postgraduate nursing programme. Students described a process of juggling to survive and succeed. Three overarching categories emerged: differing realities, working through, and learning new ways. CONCLUSIONS: This study adds to international debate regarding structures and processes supporting international nurse education. In meeting ethnic and culturally-diverse student learning needs, consideration of learning and teaching approaches is warranted. For globalisation in nurse education to prosper, investment needs to move from focusing on recruitment towards structures and processes to nurture intercultural learning.

Home students' experiences of intercultural learning: A qualitative descriptive design.

BACKGROUND: Higher education institutes are witnessing an increase in the cultural and ethnic diversity of their student population. While this adds to the learning experience, there is a dearth of evidence examining how students on nursing programmes, from different cultural and ethnic backgrounds learn with and from each other. There is need for a greater understanding of the factors that both facilitate and inhibit intercultural learning within the classroom. OBJECTIVES: This study explored the perceptions and experiences of home students on a postgraduate nursing programme, of intercultural learning within the classroom. DESIGN: A qualitative descriptive design was used. SETTINGS: Home students enrolled on a suite of postgraduate nursing programmes in one region of Ireland who were registered for co-scheduled modules with international students, were recruited to participate on a voluntary basis. PARTICIPANTS: Fourteen home students (13 females and 1 male) were purposively sampled. METHODS: Data were collected using digitally recorded one to one semi-structured interviews (ten 'face to face' and four telephone). Data were thematically analysed using a modified version of Braun and Clarke's (2006) framework. RESULTS: This study describes the value of intercultural learning in the classroom and draws attention to some of the challenges experienced by home students. Furthermore, it highlights the importance of exploring similarities, whilst respecting differences in prior educational experiences, learning styles and cultural backgrounds. The overarching theme, Navigating intercultural learning describes home students' experiences of developing awareness, connecting and sharing cultural knowledge. CONCLUSIONS: Intercultural learning takes time and requires commitment, emphasising the need for careful consideration of facilitation techniques, preparation, support and planning pedagogies that encourage effective intercultural learning. The findings make a valuable contribution to existing knowledge on internationalising nurse education, specifically with regards to intercultural relations and the perceptions and experiences of teaching and learning in intercultural classrooms.

Pre-departure preparation and co-curricular activities for Students' intercultural exchange: A mixed-methods study.

BACKGROUND: Nurses are required to be culturally competent to provide quality care to an increasingly diverse and ageing population. International exchange programmes were developed to support the traditional nursing curriculum. These programmes have often overlooked the importance of pre-departure preparation and co-curricular activities to the development of intercultural competency. OBJECTIVES: To explore the influence of pre-departure and co-curricular activities on the intercultural learning experiences of both exchange and host students in a short-term international summer programme. DESIGN: A mixed-methods study. SETTING: Students were recruited from international and mainland exchange partners, with host students as ambassadors. The international summer programme involved a week of online pre-departure activities and two weeks of face-to-face meetings. PARTICIPANTS: A convenience sample of 62 students from diverse cultural backgrounds was recruited on a voluntary basis. The participants were aged between 19 and 27. METHODS: Data were collected from students' pre- and post-visit questionnaires, discussions within the workshops, their online discussion threads, and focus group discussions. RESULTS: The quantitative findings suggested that students' cultural intelligence improved significantly after the exchange programme. Qualitatively, three themes emerged as: 1) Students' motivation to engage in intercultural learning; 2) Barriers to intercultural communication; 3) Enablers of intercultural communication. CONCLUSION: Pre-departure preparation enabled students to discuss their common goals and expectations, while exploring differences, asked for practical living information, and used the basic intercultural concepts in their discussion on the care of elderly. This virtual encounter has lay the foundation for students' subsequent discussions about the why and how the differences that inform their own practices and about global ageing and poverty issues during their co-curricular activities. While the pre-departure preparation could serve as a stimulus, the value of this programme for intercultural learning also rests with the importance of debriefing to further students' reflective and experiential learning.

Learning global health: a pilot study of an online collaborative intercultural peer group activity involving medical students in Australia and Indonesia.

BACKGROUND: There is limited research to inform effective pedagogies for teaching global health to undergraduate medical students. Theoretically, using a combination of teaching pedagogies typically used in 'international classrooms' may prove to be an effective way of learning global health. This pilot study aimed to explore the experiences of medical students in Australia and Indonesia who participated in a reciprocal intercultural participatory peer e-learning activity (RIPPLE) in global health. METHODS: Seventy-one third year medical students (49 from Australia and 22 from Indonesia) from the University of Tasmania (Australia) and the University of Nusa Cendana (Indonesia) participated in the RIPPLE activity. Participants were randomly distributed into 11 intercultural 'virtual' groups. The groups collaborated online over two weeks to study a global health topic of their choice, and each group produced a structured research abstract. Pre- and post-RIPPLE questionnaires were used to capture students' experiences of the activity. Descriptive quantitative data were analysed with Microsoft Excel and qualitative data were thematically analysed. RESULTS: Students' motivation to volunteer for this activity included: curiosity about the innovative approach to learning; wanting to expand knowledge of global health; hoping to build personal and professional relationships; and a desire to be part of an intercultural experience. Afer completing the RIPPLE program, participants reported on global health knowledge acquisition, the development of peer relationships, and insight into another culture. Barriers to achieving the learning outcomes associated with RIPPLE included problems with establishing consistent online communication, and effectively managing time to simultaneously complete RIPPLE and other curricula activities. CONCLUSIONS: Medical students from both countries found benefits in working together in small virtual groups to complement existing teaching in global health. However, our pilot study demonstrated that while intercultural collaborative peer learning activities like RIPPLE are feasible, they require robust logistical support and an awareness of the need to manage curriculum alignment in ways that facilitate more effective student engagement.