Global Learning Services In Nursing Education
What Global Service Learning
Global
service learning (GSL) refers to experiential educational programs in which
students are immersed in another community and culture, providing meaningful
service in collaboration with a partner community. GSL can take place
"around the corner and across the globe." Emphasis is placed on both
the learning (student focused) and service (community partner-focused) aspects
of programs.
High impact Nursing Programs
CSL programs are high impact educational programs (Kuh, 2008) that involve collaboration among schools of nursing (SON), partner communities, and participants/students. Driving forces for GSL participation include benefits to participants, service to the partner community, and alignment with university/ institutional mission and vision. Although nurses have a long history of providing service at both the local and international levels. the term GSL is new to nursing education.
Defining GSL and its application in nursing education are critical as nursing establishes its role in service to the global community.There has been an increase in interest and participation in global programs in SON over the past decade (McKinnon & McNelis, 2013). GSL educators work with administrators, colleagues, students, and partner communities, demonstrating competency in the areas of program development, relationship building, and coursework adaptation.
Coursework may be an extension of an existing class or may be specially designed for a non SON credit course. Educators are challenged to find a balance between the educational needs of students and service needs of the partner community.Global experiences are not defined by geographic boundaries but are inclusive of experiences in which participants are completely immersed in another community and culture. Global partners include culturally, and often linguistically, distinct communities within one's home country, as well as internationally.
Most often, GSL programs focus on low-resource/marginalized communities. In order to ensure relevance and sustainability of programs, community members must drive the focus of service activities and are involved in each step of program planning and implementation. Smith, Fitzpatrick and Hoyt-Hudson (2011) emphasize the importance of stakeholder involvement in global program development, stating, " local knowledge is a crucial input to the design and implementation of interventions" (p. 258) Learners in GSL programs may include students in nursing programs and/or practicing nurses participating in continuing education programs.
GSL provides a means of enhancing students' ability to become productive and engaged members of the global community (Tremethick & Smit, 2009). The ever-increasing multicultural population in the United States poses a significant challenge to nurses providing individualized and holistic care to their patients. This requires nurses to recognize and appreciate cultural differences in health care values, beliefs, and customs (Maier Lorentz, 2008). GSL participation leads to beneficial outcomes such as increased cultural awareness, enhanced civic engagement (Edmonds, 2012), self efficacy, and a global nursing perspective.
An example of a local GSL experience is as follows: Nursing students in a community health practicum are assigned to work in an inner-city program for recent immigrants. Collaborating with community leaders and local resource agencies, students address childhood nutrition issues by providing the following services: implementing a "train-the-trainer" program for indigenous healers enlisting the efforts of local stores to provide options for culturally relevant, low cost nutritional foods; engaging representatives from the local food bank and farmer's market; and coordinating a health fair with representation from agencies such as after-school activity programs.
An example
of an international GSL experience is as follows: Senior-level students are
assigned to work alongside students in the partner community's SON research and
identify appropriate long-term interventions for addressing the emerging issue
of caregiver role strain. Students from both institutions collaborate to design
a plan for support groups in the community. Technology is used to support the
sustainability of the program.
Impact of Global Services Learning
Global programs in SON range from study abroad to service programs. The distinction between GSL and study-abroad programs is the provision of service. Service is the act of providing something valuable to the partner community The partner community identifies specific issues to be addressed by students in the GSL program and the participant's function within their scope of practice, working collaboratively with community members to provide meaningful service with a focus on sustainability and capacity development.Experience alone does not lead to learning Kolb (1984), integrating the writings of Dewey, Lewin, and Piaget, defined experiential learning as "the process whereby knowledge is created through the transformation of experience" (p. 38).
GSL faculty create an environment that allows the transformation of a GSI. experience into valuable learning. A comprehensive approach to learning must be in place in order for the global experience to lead to increased knowledge about course content, the partner community and culture, and oneself. This includes teaching theoretical content and role development prior to the global experience, ensuring opportunities for integration (eg journaling, case conference) during the experience, and a comprehensive overview and debriefing once the program is complete.
Global Learning Services for Evaluation
Measurement of outcomes on partner community is both a research and ethically imperative for nursing. Although research is available on the impact of GSL participation on students, little is known about the effects on partner communities. Measuring the outcomes of GSL programs on partner communities is the only way to ensure ethical, evidence-based programs.McKinnon and Fealy (2011) propose core principles for GSL programs. Core principles, referred to as the "Seven Cs." include compassion, curiosity, courage, collaboration, creativity, capacity building, and competence.
According to McKinnon and Fealy, "the articulation of core principles provides for consistency across programs while allowing individual programs to maintain their uniqueness at the level of program content and focus, incorporating these principles provides for enhanced communication among programs, increased opportunity for collaborative research , and consistency of evaluation criteria" (p. 99)
Credit toward major (CTM) refers to the provision of school of-nursing credit for course-work. A study by McKinnon and McNelis (2013) identified a lack of clarity among schools regarding regulations pertaining to the provision of CTM for international practicum experiences. This uncertainty has been identified as a significant barrier to adoption of GSL programs by SON. As a result, many schools have resorted to creating high unit courses and applying extra units for the international experience. The extra units in these "work-around" offerings present a barrier to students who cannot afford to pay the additional fees, thus creating exclusionary programs.
Providing CTM for global clinical courses creates opportunities for increased student participation (cost and time) and sustainability of programs (cost and faculty time), which ultimately lead to higher-quality programs.Enhanced use of technology presents unique opportunities for GSL partners. The use of simulation to train students prior to the immersion experience, using modalities such as Skype to communicate with global partners during the planning phase, and connecting students on-site during the immersion with students in the classroom at the home institution are all examples of ways in which technology can enhance the GSL experience for all partners.
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