Global Learning In Nursing Education

What Is Global Learning

    Global
learning in nursing education is an integrated comprehensive framework that
provides students with multiple ways of learning, including theoretical,
experiential, and reflexive learning Global learning is “a critical
analysis of and an engagement with complex, interdependent global systems and
legacies (such as natural , physical, social, cultural, economic, and
political) and their implications for people’s lives and the earth’s
sustainability” (Rhodes, 2010) Through reflective and critical thinking,
global learning provides students with a deeper understanding of themselves and
members of the global community , both “around the corner and across the
globe.” 

Implementation of Global Nursing Education

    Nurses
need to be educated as global citizens who have a moral responsibility and
professional competency to care and promote health beyond their local
communities and national institutions (Chavez, Peter, & Gastaldo, 2008).
The new global interdependence calls for all persons across the globe to extend
their thinking about moral responsibility and health beyond their local
communities and national citizenship and to become citizens of the world
(Crigger, Brannigan, & Baird, 2006). Nussbaum (1997) describes three
capacities necessary for the cultivation of global citizenship. 

    The first is
reflexivity, the capacity to examine our beliefs, traditions, habits, and
ourselves: critically. Nussbaum’s second capacity for global citizenship
entails the notion of “moral cosmopolitanism,” meaning adopting the
fundamental view of all persons as fellow citizens who have equal moral worth
and deserve equal moral consideration. Narrative imagination is the third
capacity. 

    This requires the ability to imagine what it might be like to be a
person different from oneself, and to allow such imagination to inform
understanding of the other person’s experiences, emotions, and desires
(Nussbaum, 1997). Being exposed to other cultures and people is one aspect of
developing this kind of narrative imagination (Chavez, Bender, & Gastaldo,
2011).

    A
theoretical framework in global learning, specifically postcolonial framework,
provides an analytic lens to look at the impact of health with the intersecting
factors of power, race, gender, and social class. Postcolonial feminism
represents an opportunity for nurses to acknowledge their multiple locations as
individuals and health care professionals. It challenges deeply held ce rtainties
about the “right way” to provide care and values all knowledge as
being situated within a given place and within the power relations therein. 

    Using this perspective enables us to consider multiple perspectives on meanings
of health and illness (Anderson & McCann, 2002), as well as the complex
issues associated with the global locations of nursing practice.Through
global learning, nursing students become sensitized to their own culturally
established perspectives on health care and become capable of identifying and
challenging underlying values and assumptions of their nursing education and
practice. They are able to examine how social inequalities are located and
constructed within a political, historical, cultural, and economic context.

Impact of Global Nursing Education

    Over
a decade ago, Thorne (1997) argued that nursing education has traditionally
fostered social awareness within a limited local sphere of influence. At that
time, the literature reflected an ongoing interest in international nursing and
an inherent goodness of educational exchange programs. However, there was
little analysis of what motivates students or, beyond simply providing
“practical” experience, how leaders/teachers promote an attitudinal
shift in students involved in such programs (Thome, 1997).

     Studying the
experiences of globally aware nurses, Thorne specifically explored the origins
of their global awareness and their analysis of nursing as a whole in relation
to the larger global perspective, in order to shed light on these more critical
questions. Findings raised two key points regarding nursing education
specifically. First, most of these nurses reported little or no formal learning
in their nursing programs on topics they considered relevant to a global
perspective. Second, some noted that their desire to incorporate preexisting
interest in global health into their clinical learning was generally not
supported, either by faculty or peers. 

    Nursing education that recognizes the
importance of cultural sensitivity in cultivating global consciousness ought to
encourage “critical analysis of the status quo in health care and the
larger society” (Thorne, 1997, p. 440). In this vein, international
exchange programs offer particularly rich learning with regard to alternative
(ie, non-Western) health and social structures. She concluded by calling for a
reexamination of uncritical approaches to international nursing work with their
roots in colonial paternalism, those framed simply as charitable efforts to
assist needy nations. 

    Some of the recurring benefits that appear in
international nursing studies can inform the impact of global learning.
Benefits of international experiences include changed values, increased
consciousness of social justice and global health issues, significantly
improved communication skills, learning to think unconventionally about other
cultures, development of confidence, growth in competency, and the therapeutic
use of self (Evanson & Zust , 2006; Lee, 2004; Mill, Yonge, & Cameron,
2005; Sloand, Bower, le Groves, 2005)

Outcome of Global Learning

    While
there is increasing emergence and investment in many forms of global learning
interchangeably used for global service learning, global health practical,
international placements/exchange, and so on, systematic evaluation receives
comparatively less attention. While nursing researchers have begun to evaluate
the effectiveness of student learning within local contexts, a challenge exists
in applying their findings to international settings, settings that represent a
complexity of factors that influence learning in particular ways (Stufflebeam,
2001). 

    There is a need for more tested strategies to evaluate learning and
practice related to international experiences and global learning evaluation
results will contribute to a growing body of evidence supporting the
integration of global learning in nursing education. Evaluation of Critical
Perspectives in Global Health (CPGH) rein- forces many of the common themes
reflective of transformative learning, CPGH, like many global learning
initiatives, can only accommodate limited numbers of students and continue to
be an elective course instead. of a credit course. This begs the question as to
why many nursing curricula do not integrate global learning as a required or
foundational course.