Global Awareness, Adapting and Preparation for Service Learning In Nursing Education

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Nursing Education and Global Awareness, Adapting and Preparation for Service Learning

Global Awareness, Adapting and Preparation for Service Learning In Nursing Education

Global Awareness Through Service Learning In Nursing Education, Adapting Service Learning for Distance Education In Nursing, Global Awareness Through Service Learning In Nursing Education, Adapting Service Learning for Distance Education In  Nursing, Preparation for Service Learning In Nursing Education.

Global Awareness Through Service Learning In Nursing Education

    Global service learning programs support global citizenship, provide an understanding of diverse cultural communities, and promote a paradigm shift to global citizenship and global health care (Burgess, Reimer Kirkham, & Astle, 2014; McKinnon & Fealy, 2011). Global citizens “identify not primarily or solely with their own nation but also with communities of people and nations beyond the nation-state boundaries” (Abowitz & Harnish, 2006, p. 675). 

    Global citizenship expands the boundaries of social justice concerns beyond one's own city, state, and nation. McKinnon and Fealy (2011) believe that global service-learning programs should be built around the Seven Cs of Best Practice: “compassion, competence, curiosity, capacity building, courage, creativity, and collaboration” (p. 95). 

  Collaboration is key to foster partnership and avoid cultural and linguistic misunderstanding. Despite the increased interest in global health care, fewer than half of US nursing programs offer international service opportunities and faculty identify significant obstacles to developing new programs such as cost, time, interest, and logistics (McKinnon & McNelis, 2013). 

    Help for faculty in overcoming obstacles can be located in the National League for Nursing (2012) resource Faculty Preparation for Global Experiences Toolkit. The course objectives and needs of the host community must be linked in deliberate ways to meet the needs of both groups. 

    One school set up an experience in Nicaragua for students who conducted a nutritional needs assessment; provided prenatal education for community health workers and lay midwives, with a special emphasis on nutrition; and supported the relief efforts in refugee camps following Hurricane Mitch (Riner & Becklenberg, 2001). 

    Students were provided with information about the Nicaraguan culture before starting the experience. This is critical because the ability to provide culturally responsive health care is important. In an interdisciplinary global service project, a school brought a mobile medical clinical to Honduras staffed by nurse practitioner students, baccalaureate nursing students, and medical students (Green, Comer, Elliott, & Neubrander, 2011). 

   Another school set up a 2-week immersion experience in Guatemala for senior baccalaureate nursing students who provided nursing assessments and health teaching at prenatal and well child clinics, an adult day program, and rural health clinics (Curtin, Martins, Schwartz Barcott, DiMaria, & Ogando, 2013). 

    The faculty provided seminars about the culture and language prior to the trip, and used journals and postexperience seminars to facilitate reflection on the experience. The faculty identified that by linking the reflective process to curricular goals and the nursing program mission, students were able to articulate learning about global engagement, cultural awareness, and building professional competence (Curtin et al., 2013). 

    International travel involves additional steps and advance planning, including learning about the host country and its culture, getting passports, arranging for a translator if a foreign language is spoken, vaccinations (for some regions), and arranging for safe accommodations. 

    The Center for Global Education provides a variety of helpful information that assists with preparation and the US Department of State Bureau of Consular Affairs has an Overseas Travel Checklist that is also helpful. Travelers may wish to be accompanied by a familiar guide with the area to enhance safety and should travel in groups at all times.

   The US Department of State Bureau of Consular Affairs is a resource for region specific travel and health warnings when traveling abroad. Additional vaccinations may be needed. Health concerns vary by region and may include traveler's diarrhea, Ebola, yellow fever, and typhoid. Students should check their medical insurance to identify what it will cover when traveling abroad should they become ill. 

    When traveling abroad, communication via telephone and Internet may be limited. Contacting cellular providers ahead of time can avoid last-minute problems. Apps are designed for international travel and may be helpful in language translation and for phone and text message service. Internet access may be limited, but some countries have Internet cafes where service is available. 

    Organizations such as the International Service-Learning Alliance and the International Partnership for Service Learning and Leadership may be helpful sources of information. Although international travel takes more time and effort to plan, it helps prepare nurses for the diverse world in which they live by enhancing cultural knowledge, commitment to global social needs, and forming valuable global connections (Crabtree, 2013).

Adapting Service Learning for Distance Education In Nursing

    Service learning has traditionally been structured as part of an on ground nursing program. However, as more and more programs move in whole or in part to distance education, consideration must be given to service-learning experiences for this student population. Service learning for distance learning students can occur in a number of ways. 

   First, the online student can identify a community partner in his or her local community for a service experience and take advantage of online learning technologies. For example, faculty teaching an online RN to BSN leadership course used service learning to enhance the collaborative teaching learning relationship and provide a venue for a required change project (Anderson & Miller, 2007). 

   An asynchronous forum allowed discussions with opportunities for reflection. Descriptions of agencies and service projects used by on campus students were posted online to help distance education students find comparable experiences within their own community. Faculty members worked collaboratively with students to finalize arrangements with those agencies. 

    Second, the students enrolled in an online program could travel to an international site for a service-learning experience together with other students enrolled in the course (whether online or on ground). Third, the service could become e-service learning. This would overcome the traditional time and geographic boundaries and allow students to conduct their service online. 

    E-service learning provides opportunities for engagement, skill building, and practical experience that might otherwise be limited or lacking in an online course (Waldner, Mc Gorry, & Widener, 2012). 

    E-service learning requires both the student and the community partner to have access to technology (chat rooms, e-mail, videoconferencing, Skype, wikis, or discussion boards), but it removes the traditional geographic boundaries. 

    Best practices for e-service learning include providing training on any technology that will need to be used, creating clear written communication of expectations between students and community partners, scheduling meeting times to enhance communication, and maintaining faculty engagement throughout the e-service learning experience (Waldner et al., 2012). 

    Using these guidelines, service learning opportunities can be expanded to distance education students. 

Global Awareness Through Service Learning In Nursing Education

    Global service learning programs support global citizenship, provide an understanding of diverse cultural communities, and promote a paradigm shift to global citizenship and global health care (Burgess, Reimer-Kirkham, & Astle, 2014; McKinnon & Fealy, 2011). Global citizens “identify not primarily or solely with their own nation but also with communities of people and nations beyond the nation-state boundaries” (Abowitz & Harnish, 2006, p. 675). 

    Global citizenship expands the boundaries of social justice concerns beyond one's own city, state, and nation. McKinnon and Fealy (2011) believe that global service-learning programs should be built around the Seven Cs of Best Practice: “compassion, competence, curiosity, capacity building, courage, creativity, and collaboration” (p. 95). 

  Collaboration is key to foster partnership and avoid cultural and linguistic misunderstanding. Despite the increased interest in global health care, fewer than half of US nursing programs offer international service opportunities and faculty identify significant obstacles to developing new programs such as cost, time, interest, and logistics (McKinnon & McNelis, 2013). 

    Help for faculty in overcoming obstacles can be located in the National League for Nursing (2012) resource Faculty Preparation for Global Experiences Toolkit. The course objectives and needs of the host community must be linked in deliberate ways to meet the needs of both groups. 

    One school set up an experience in Nicaragua for students who conducted a nutritional needs assessment; provided prenatal education for community health workers and lay midwives, with a special emphasis on nutrition; and supported the relief efforts in refugee camps following Hurricane Mitch (Riner & Becklenberg, 2001). 

    Students were provided with information about the Nicaraguan culture before starting the experience. This is critical because the ability to provide culturally responsive health care is important. In an interdisciplinary global service project, a school brought a mobile medical clinical to Honduras staffed by nurse practitioner students, baccalaureate nursing students, and medical students (Green, Comer, Elliott, & Neubrander, 2011). 

   Another school set up a 2-week immersion experience in Guatemala for senior baccalaureate nursing students who provided nursing assessments and health teaching at prenatal and well child clinics, an adult day program, and rural health clinics (Curtin, Martins, Schwartz Barcott, DiMaria, & Ogando, 2013). 

    The faculty provided seminars about the culture and language prior to the trip, and used journals and postexperience seminars to facilitate reflection on the experience. The faculty identified that by linking the reflective process to curricular goals and the nursing program mission, students were able to articulate learning about global engagement, cultural awareness, and building professional competence (Curtin et al., 2013).

    International travel involves additional steps and advance planning, including learning about the host country and its culture, getting passports, arranging for a translator if a foreign language is spoken, vaccinations (for some regions), and arranging for safe accommodations. 

    The Center for Global Education provides a variety of helpful information that assists with preparation and the US Department of State Bureau of Consular Affairs has an Overseas Travel Checklist that is also helpful. Travelers may wish to be accompanied by a familiar guide with the area to enhance safety and should travel in groups at all times. 

   The US Department of State Bureau of Consular Affairs is a resource for region-specific travel and health warnings when traveling abroad. Additional vaccinations may be needed. Health concerns vary by region and may include traveler's diarrhea, Ebola, yellow fever, and typhoid. 

    Students should check their medical insurance to identify what it will cover when traveling abroad should they become ill. When traveling abroad, communication via telephone and Internet may be limited. Contacting cellular providers ahead of time can avoid last-minute problems. 

    Apps are designed for international travel and may be helpful in language translation and for phone and text message service. Internet access may be limited, but some countries have Internet cafes where service is available. Organizations such as the International Service Learning Alliance and the International Partnership for Service Learning and Leadership may be helpful sources of information. 

    Although international travel takes more time and effort to plan, it helps prepare nurses for the diverse world in which they live by enhancing cultural knowledge, commitment to global social needs, and forming valuable global connections (Crabtree, 2013).

Adapting Service Learning for Distance Education In  Nursing 

    Service learning has traditionally been structured as part of an on ground nursing program. However, as more and more programs move in whole or in part to distance education, consideration must be given to service-learning experiences for this student population. Service learning for distance learning students can occur in a number of ways. 

   First, the online student can identify a community partner in his or her local community for a service experience and take advantage of online learning technologies. For example, faculty teaching an online RN to BSN leadership course used service learning to enhance the collaborative teaching learning relationship and provide a venue for a required change project (Anderson & Miller, 2007). 

   An asynchronous forum allowed discussions with opportunities for reflection. Descriptions of agencies and service projects used by on-campus students were posted online to help distance education students find comparable experiences within their own community. 

    Faculty members worked collaboratively with students to finalize arrangements with those agencies. Second, the students enrolled in an online program could travel to an international site for a service learning experience together with other students enrolled in the course (whether online or on-ground). 

   Third, the service could become e-service learning. This would overcome the traditional time and geographic boundaries and allow students to conduct their service online. E-service learning provides opportunities for engagement, skill building, and practical experience that might otherwise be limited or lacking in an online course (Waldner, McGorry, & Widener, 2012). 

    E-service learning requires both the student and the community partner to have access to technology (chat rooms, e-mail, videoconferencing, Skype, wikis, or discussion boards), but it removes the traditional geographic boundaries. 

    Best practices for e-service learning include providing training on any technology that will need to be used, creating clear written communication of expectations between students and community partners, scheduling meeting times to enhance communication, and maintaining faculty engagement throughout the e-service learning experience (Waldner et al., 2012). 

    Using these guidelines, service-learning opportunities can be expanded to distance education students.

Preparation for Service Learning In Nursing Education

    Eleven student placements and focus of the service have been selected, preparation must extend to the classroom setting. Conceiving of service learning as simply a matter of mutually beneficial service ignores the important concept of readiness for the encounter. 

    Radest (1993) introduced the idea of solidarity: “the name of my relationship to the stranger who remains unknown—only a person in an abstract sense—but who is, like me, a human being. Solidarity is then a preparation for the future and at the same time a grounding in the present” (p. 183). 

   Sheffield (2005) notes that “Radest's concept of solidarity develops into a disposition toward democratic interaction and service” (p. 49) and that academic preparation for the encounter is essential. Preparation develops a sense of understanding in students that gives increased meaning to the service and a realization that strangers are much like them, further developing the sense of solidarity. 

    Preparation should include exploration of social issues as well as an introduction to the service environment and the people who will be encountered. It can take the form of reading materials from the agency, reading text-based materials, exploring material available on the Internet, or viewing films, and should be accompanied by discussions to prepare students for the service experience. 

    Preparatory classroom activities should have an overall goal of enhancing understanding and helping the stranger become familiar. Sheffield (2005) notes that “academic preparation not only undergirds the particular service activity, but also advances solidarity generally for future encounters with future 'strangers' and develops a habit of readiness to interact open-mindedly with others” (p. 52). 

    Preparation also brings participants a greater understanding of diversity, the ability to embrace and celebrate differences, and a realization of their ethical responsibility to connect with others in the community. Sheffield (2005) notes that “without that understanding, service degenerates into volunteerism where act rather than connection is the focus” (p. 52).

    Eleven student placements and focus of the service have been selected, preparation must extend to the classroom setting. Conceiving of service learning as simply a matter of mutually beneficial service ignores the important concept of readiness for the encounter. 

    Radest (1993) introduced the idea of solidarity: “the name of my relationship to the stranger who remains unknown only a person in an abstract sense but who is, like me, a human being. Solidarity is then a preparation for the future and at the same time a grounding in the present” (p. 183). 

    Sheffield (2005) notes that “Radest's concept of solidarity develops into a disposition toward democratic interaction and service” (p. 49) and that academic preparation for the encounter is essential. Preparation develops a sense of understanding in students that gives increased meaning to the service and a realization that strangers are much like them, further developing the sense of solidarity. 

    Preparation should include exploration of social issues as well as an introduction to the service environment and the people who will be encountered. It can take the form of reading materials from the agency, reading text based materials, exploring material available on the Internet, or viewing films, and should be accompanied by discussions to prepare students for the service experience. 

    Preparatory classroom activities should have an overall goal of enhancing understanding and helping the stranger become familiar. Sheffield (2005) notes that “academic preparation not only undergirds the particular service activity, but also advances solidarity generally for future encounters with future 'strangers' and develops a habit of readiness to interact open-mindedly with others” (p. 52). 

    Preparation also brings participants a greater understanding of diversity, the ability to embrace and celebrate differences, and a realization of their ethical responsibility to connect with others in the community. Sheffield (2005) notes that “without that understanding, service degenerates into volunteerism where act rather than connection is the focus” (p. 52).

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