Collaborative Approaches to Supporting Pre- Health Professional, Nursing, and Health Sciences Undergraduate Students in Education Abroad

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1 Collaborative Approaches to Supporting Pre- Health Professional, Nursing, and Health Sciences Undergraduate Students in Education Abroad Scott Daby, University of Minnesota- Learning Abroad Center Nicole Letawsky Shultz, University of Minnesota- College of Biological Sciences Tricia Todd- University of Minnesota- Health Careers Center Jason Kinnear- University of Missouri- Office of Service Learning Lynelle Phillips, University of Missouri- Sinclair School of Nursing Daniela Ascarelli, Drexel University- Drexel Study Abroad

2 What do you hope to learn today?

3 Challenges to Going Abroad for Pre-health Students Course sequencing Timing Professional program entrance and licensure requirements Concerns about grades Relevant and ethical programs Competition from other resume enhancing activities

4 Collaborative Premise If you bring the appropriate people together in constructive ways with good information, they will create authentic visions and strategies for addressing the shared concerns of the organization and community. David Chrislip

5 Characteristics of Good Collaboration Should we collaborate? Having the right reason Choosing the right collaborators - inclusive Creating a shared vision and process Committing equitable resources Honoring the values of collaboration (trust, safety, clarity, transparency, respect

6

7 Health Careers Center College of Liberal Arts College of Biological Sciences College of Science and Engineering College of Food, Agriculture, and Natural Resource Sciences College of Education and Human Development College of Continuing Education Carlson School of Management College of Pharmacy College of Vet Med Medical school School of Dentistry School of Nursing School of Public Health Center for Allied Health

8 What is a pre-health student Any student interested in a future health career Clinical and public health Any major Any age

9 Why are pre-health students different Highly Competitive (GPA ) Very focused and driven Begin as pre-med Pre-requisites are extensive 3 dimensional applicants to be competitive

10 Collaborating to build future health professionals We understand health professions We understand global health ethics and competencies We understand hospitals, clinics and community health You understand study abroad! You understand study abroad!! You understand study abroad!!!

11 How a global experience Health and disease are global prepares a student Cultural respect is essential for care-givers and public health professionals Expanded understanding of belief systems and how they influence health and behavior Recognition of how health is influenced by social factors (SDOH)

12 The Global Future Physician

13 Collaboration Gives Results Forum Guidelines for Pre Health Programs

14 what about us?

15 find a partner

16

17 visible pathways

18 study abroad here!

19 not here!

20

21

22 Develop Relevant Experiences Abroad Ecuador- Health & Society Tanzania- Public Health & Medicine India- Global Future Physicians Argentina- new course on mental health Denmark- clinical research course with DIS

23 Education Abroad and the Health Sciences Drexel Study Abroad Office

24 Drexel University Located in Philadelphia TOTAL 25,000 students UG students 4600 GR students 1500 professional MS students 1600 online UG students 3400 online GR students (includes many SPH and CNHP students) Co-op school Quarter calendar

25 College of Nursing and Health Professions (CNHP) Undergraduate Nursing RN to BSN dept BS in Science of Nursing Undergraduate Health professions Behavioral Health Health Administration Nutrition Sciences Pathways to Health Professions Graduate Nursing Couple and Family Therapy Creative Arts Therapy Nutrition Sciences Physical Therapy Physicians Asst

26 CNHP On Line programs: Doctor of Nursing Practice MHS in Physician Assistant MSN Adult-Gerontology Acute Care Nurse Practitioner MSN Clinical Nurse Leader MSN Family Nurse Practitioner MSN in Clinical Trials Research MSN in Innovation and Intra- Entrepreneurship in Advanced Nursing Practice MSN in Nursing Education and Faculty Role MSN in Nursing Leadership in Health Systems Management MSN Pediatric Primary Care Nurse Practitioner MSN Psychiatric Mental Health Nurse Practitioner MSN Women s Health/Gender Related Nurse Practitioner RN-MSN Bridge Program

27 School of Public Health (SPH) Masters in Public Health Community Health Prevention Environmental and Occupational Health Epidemiology Health Management and Policy Biostatistics BS in Public Health Minor in Public Health Certificate offerings Certificate in Global Health

28 Drexel College of Medicine (DUCOM) MD program Biomedical Sciences and Professional Studies

29 2001: SA worked with DUCOM post 9/11 to establish check list for intl residencies : UG health professions students able to go on any DU study abroad program 2006: SA collaborated with CNHP in creating a 2 week residency for DrNHP students 2008: SA created study abroad opportunity in London for UG Nursing and Health professions students

30 AY : UG physical therapy students go to Guatemala CNHP students encouraged to go to Costa Rica during their vacation summer. Exploration of options with existing exchange partners and service providers

31 AY Changes in strategic goals of university SA moves to forefront of strategic plan which involves funding beginning July 1, 2012 Enhancing Drexel s Global Impact Associate Dean of Global Health hired by SPH One University initiative DUCOM sees surge in interest in intl opportunities

32 AY Haiti initiatives launched: FNP clinical intensive June 2012 Discussions begin with CNHP to develop a short program in Israel focusing on maternal health.

33 AY 2012/2013 November- December 2012: advertise and hire SA asst director position January 2013 Costa Rica UG nursing study abroad initiative Haiti initiatives expanded: March 2013 PA and psych mental health NP March 2013 CNHP hire Director of Global Studies ( new position) Summer 2013 Drexel Global Health certificate students in Senegambia Summer 2013 Global Field practice opportunity & guidelines launched by SA/SPH

34 AY 2013/14 Fall 2013 GR physical therapy students intl rotations: Italy and Germany SA involved in assisting DUCOM to capture students going abroad between year 1 and year 2 SA and DUCOM revisiting approval process for 4 th year intl special electives. June 2014: RN to BSN Paraguay program Haiti initiatives expand again: March 2014 Women s health and pediatric nurse practitioners as well as, FNP and PA and Psych mental health

35 Other international initiatives: Global Classroom International Travel Awards for faculty and grad students International Experiences Break in programs Travel embedded courses

36 Daniela Ascarelli Assistant Vice Provost, International Programs Director, Drexel Study Abroad

37 Challenges and Successes

38 Jason Kinnear, Associate Director of Service Learning, University of Missouri Lynelle Phillips, MPH, RN, Instructor/Field Placement Coordinator, University of Missouri

39 Unequal treatment Disparity in health care Disparity in health outcomes Workforce diversity A diverse population should be served by a diverse healthcare workforce Cultural humility/competency Increase cultural competency in health care workforce Classroom instruction/exercise Immersion experience

40 Latest Open Doors: 283,332 students studied abroad in 2011/12 16, 138 (5.7%) classified as health sciences (presumably with a small amount of these being nursing students) MU no different - nursing students were woefully underrepresented in study abroad numbers

41 Bachelors of Science in Nursing (BSN) Typically 1 2 years prenursing coursework, then formal application to a school of nursing Very competitive 8 12 semesters jam packed Community health nursing required in BSN curriculum At MU - Nursing in Communities required in 8th semester (concurrent with Med Surg II) 5 credit hours 3 classroom + 2 clinical experience (90 hours logged time in the field) Writing intensive and capstone

42 Intensely regimented and rigorous curriculum Equivalency of course work and transfer credit Requirements for nursing certification Lack of awareness & lack of faculty encouragemen Limited faculty experience abroad University liability concerns Funding/Finances Comfort zone issues

43 Multi-phase, mixed methods study seeks to describe existing study abroad programs, and strategies to overcome barriers for incorporating these programs into U.S. nursing education. Phase I - online survey of nursing programs and study abroad offices. Seek to capture study abroad practices and perceived barriers Phase II - phone interviews with selected respondents to online survey. In-depth description of programs that consistently implement programs Seek to identify successful programs and strategies for overcoming barriers

44 Advantages of study abroad - students gain: To adapt to new environments (66% strongly agree) Increased global awareness (94% strongly agree) Increased adaptability (77% strongly agree) Increased levels of cultural competency (83% strongly agree) Significant barriers to study abroad: Financial constraints of schools (61% agree) Financial constraints of students (61% strongly agree) No place in the curriculum (66% agree) Other issues address not considered significant barriers Not part of NCLEX; not a requirement for accreditation, liability or health & safety concerns, lack of student interest, lack of administration or faculty support

45 Incorporated 2 week study abroad option in either January or August intersession prior to 8th semester Fulfilled the 90 hour community clinical requirement Focused on community health (population-based nursing rather than clinical nursing skill development) Participation: WB 2010/11 Ghana - 13 students, 1 faculty Aug students, 1 faculty WB 2011/12 Ghana - 11 students, 1 faculty Aug 2012 Ghana - 10 students, 1 faculty WB 2012/13 Ghana - 10 students, 1 faculty; South Africa - 11 students, 1 faculty Aug 2013 Ghana - 10 students, 1 faculty WB 2013/14 Ghana - 11 students, 1 faculty; Costa Rica 13 students, 2 faculty

46 Prevention, control, stigma infectious diseases HIV/AIDS STDs Malaria HTN DM Family planning Mental health Substance abuse Education Skits Handouts Teaching Counseling Screening HIV/AIDS DM HTN

47 Community health /Cultural competency assessment Pre/post test Likert Scale questions Free write questions 4 throughout Describe how your experience will impact nursing practice Pre/post test short essay questions How do our cultures differ? What makes people healthy? What makes people happy?

48 How do you think our cultures differ? Before program Ghana has little authority, enforced laws, and scarce electricity, water, air conditioning. The roads are unkempt and dirty and people dress in loud patterned clothing. Post program Ghanaians are very positive people who have very little and work very hard while Americans work hard, have many material possessions and tend to be negative. It is a lesson to be learned that materials cannot make a person happy.

49 "There are a lot of solutions that might work for some people but not for others. A lot of the things we started teaching about in the beginning ended up not really being possible for the people here. I learned that it is important to take into account where a patient comes from and what is available to them when teaching about health. "Everyone has a different background, personality and worldview. As a nurse it is important to honor and foster these aspects of the person you are caring for."

50 Continued research study Content analysis of journals

51 Nursing students should study abroad!!! Models exist to successfully incorporate study abroad into nursing programs work with study abroad organizations that focus on health two weeks makes a difference!!! Potential barriers nursing schools may want to start small faculty will need much encouragement

52 Students impact health in Africa: nity-health/ghana-trip.php SAAC Award Winner: Creating healthy communities: nity-health/index.php

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