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.