There is an increased need for health professions students, including nurses, to learn how to work effectively with people of other cultures. As Kako and Klinbeil describe, integrating students from various health professions into an international educational experience can facilitate learning to improve collaboration and deliver culturally safe care.
Many universities offer study abroad programs, with the goal of exposing students to different cultures and enhancing cultural competency. In March 2023, students from Molloy University participated in a short study abroad program in Kerala, India, where they visited local hospitals and rural communities. These visits exposed students to the challenges and innovations within the Indian healthcare infrastructure. The experience facilitated the application of theoretical knowledge to real-world scenarios, emphasizing the importance of cultural sensitivity when providing care.
The retrospective analysis of this study abroad program underscores its positive impact on nursing students’ personal and professional development. Through engagement with nursing colleges, hospitals, and remote communities, the university’s program succeeded in preparing students for the challenges of nursing practice in a globalized and diverse healthcare environment.
Cultural competence, which is learned over time through inner reflection, awareness, knowledge, and skill aids in providing quality healthcare to patients from diverse backgrounds. India has vast diversity of culture, language, religion, and socioeconomic status. Molloy’s study abroad program targeted a range of educational and culturally diverse activities to expose students to classroom lectures, field trips to important monuments, tours, presentations at international seminars, and volunteer opportunities. All of these activities allowed students to interact and learn from the faculty, instructors, coaches, and residents of the host country.
Nursing students interacted with a range of patients, which aided their appreciation and understanding of cultural variations in health beliefs, practices, and values. Students demonstrated motivation to leave their comfort zone and enter a challenging environment where the language, customs, and traditions were all very different.
Many students described the program as a once-in-a-lifetime experience that helped them grow and mature in their perspective of seeing the world through a different lens. The program helped to prepare nursing students to care for diverse clients by learning about the different cultures and ethnic backgrounds of the people in India and understanding their values, beliefs, religions, health, and economic systems. Huffman and colleagues noted that nursing has recognized the need for multilingual proficiency, cross-cultural awareness and sensitivity, global networking, and information sharing as necessary nursing skills.
Graduate healthcare professionals should be culturally competent, learn to be socially engaged with all ethnic groups, and develop skills to work effectively in a globally interconnected environment. For this reason, Molloy and other universities across the nation participate in study abroad programs to prepare students for global competence. Kako and Klingbeil noted that students who traveled internationally shared that they had life-changing experiences that will alter the way they deliver healthcare to diverse populations.
Emerging trends of study abroad programs in the US
The Institute of International Education (IIE) provides an excellent resource for understanding the growing emphasis on acquiring global skills like intercultural competence. Their publications, such as the “Open Doors Report,” provide valuable insights into international student mobility trends, including the skills and experiences students seek while studying abroad. IIE’s research delves into the importance of intercultural competence and its role in today’s interconnected world, offering data-driven perspectives on how students can develop these skills through study abroad programs.
There is a growing emphasis on acquiring global skills—such as intercultural competence, adaptability, and language proficiency—beyond traditional academic learning. Many study abroad programs foster these skills by incorporating internships, service-learning projects, or cultural immersion experiences. Customized programs tailored to specific academic interests or career paths are also increasing. Students are exploring study destinations beyond the conventional choices. Emerging countries and regions, especially Asia and Latin America, have become increasingly popular due to unique cultural experiences and educational offerings.
Benefits of study abroad programs for nursing students
Molloy’s study abroad program in India allowed nursing students to engage with local communities and participate in public health initiatives. These experiences deepened students’ understanding of the social determinants of health and the importance of community-based care. Traveling to a very different country helped them see and learn about the culture and experience its rich traditions. In this way, the students can incorporate what they’ve learned during their experiences outside the United States into their patient care settings.
While in India, students visited several nursing colleges and had opportunities to interact with students and learn firsthand about their education and clinical experiences. Nursing students were encouraged to reflect on their own cultural backgrounds and how these factors might influence their interactions with patients from different cultural backgrounds.
Theoretical framework to evaluate the effectiveness of the study abroad program in India
The Campinha-Bacote Model of Cultural Competence in the Delivery of Healthcare Services is a comprehensive framework designed to guide healthcare professionals in providing culturally competent care. Developed by Dr. Josepha Campinha-Bacote, this model consists of five constructs or components of culture: awareness, knowledge, skill, encounters, and desires. This involves an examination of one’s own cultural beliefs, values, biases, and attitudes.
On the Molloy trip to India, students were encouraged to examine and talk about their own culture, values, and beliefs, and then explore the cultural differences in various states of India. As future healthcare providers, they were asked to reflect on how these factors might influence their interactions with patients from different cultural backgrounds. Students were also encouraged to mingle with students of the various colleges of nursing to learn about cultural practices, values, beliefs, and health behaviors of the diverse patient populations they care for. As a result, students took an interest in learning certain skills for effective communication and interaction with patients from Indian cultures. These experiences enhanced their ability to adapt and communicate in a multicultural healthcare setting.
Personal and professional development of this study abroad program
The Molloy study abroad program in India fostered cultural sensitivity, empathy, and adaptability while enhancing nurses’ ability to provide holistic, patient-centered care in an increasingly globalized healthcare landscape. Huffman and colleagues stated that nursing students who study abroad reap benefits far beyond intercultural communication and sensitivity. Even a short-term experience can represent a critical experience that sparks further learning and growth.
Before the short-term study abroad program in India, the students participated in a 5-week preparatory course. The syllabus for this course included topics such as cultural competence and humility, Kerala people and culture, and healthcare in Kerala. The objective of the course was for students to understand Indian cultures, practices, and current and past healthcare practices. The course concluded with the 10-day trip to India.
Rotations included going into the community and providing basic assessments, such as blood pressure screening and blood glucose monitoring. After the community assessments, students observed presentations about healthy lifestyles and healthy food choices, which the Indian nursing students presented to the local community during their clinical rotations. This allowed the nursing students to learn how community nursing education is conducted in another country.
Molloy’s program in India serves as a model for nursing education, highlighting the significance of cultural competence in delivering quality patient care in an increasingly diverse world. Such programs advance global healthcare and promote health equity by preparing nursing students to work effectively in multicultural healthcare environments.
Dr. Anna George, Ph.D, APRN, RN, FNP-C, is an associate professor; Dr. Victoria Siegel, EdD, RN, CNS, is a professor; Kim Langenmayr, Ph.D., is Director of International Education, all at Molloy University, Rockville Centre, NY; Shannon Boyle, BSN, RN, is a nurse at South Shore University, Bay Shore, NY.
References
Campinha-Bacote J. Cultural competence: A paradigm shift in the cultural competence versus cultural humility debate – Part I. OJIN: The Online Journal of Issues in Nursing. 2019;24(1).doi:10.3912/OJIN.Vol24No01PPT20
Campinha-Bacote J. The process of cultural competence in the delivery of healthcare services. Transcultural C.A.R.E. Associates. https://transculturalcare.net/the-process-of-cultural-competence-in-the-delivery-of-healthcare-services/
Cho M, Kim MY. Factors affecting the global health and cultural competencies of nursing students. Int J Environ Res Public Health. 2022;19(7):4109. doi:10.3390/ijerph19074109
Huffman J, Inoue M, Asahara K, et al. Learning experiences and identity development of Japanese nursing students through study abroad: A qualitative analysis. Int J Med Educ. 2020;11:54-61. doi:10.5116/ijme.5e47.cf1b
Kako PM, Klingbeil CG. Facilitating cultural humility and attunement for nursing and health professions students through a study abroad program in Kenya. Nurs Educ Perspect. 2019;40(5):278-82. doi:10.1097/01.NEP.0000000000000561
Kosman BA, Etxebarria N, Chipchase LS. The impact of learning abroad programs in developing countries: A scoping review. Nurse Educ Today. 2021;97:104716. doi:10.1016/j.nedt.2020.104716
Meaux JB, Saviers B, Traywick L. Effects of study abroad on cultural and interprofessional competencies. Nurse Educ Today. 2021;103:104928. doi:10.1016/j.nedt.2021.104928
Open Doors. Asia. opendoorsdata.org/fact_sheets/asia
