RESUMEN

This article sets out key issues in determining and upholding the best interests of children, in need of social service support, who have family networks that span outside of the UK. These issues are then analysed against whether and how child protection professionals take these into account along with an overall consideration of the United Nations Convention on the Rights of the Child's (UNCRC) 'best interests of the child', when assessing and planning for those needs in kinship care cases. Building on these themes, the findings of an exploratory study on international kinship care cases carried out by Children and Families Across Borders (CFAB), the UK branch of the non-governmental organisation, International Social Service, as well as CFAB's associated Freedom of Information Requests to the UK government, are examined. These are then analysed in relation to legal and policy documents in England. Agency case records are analysed to identify a range of factors for children placed with 'kinship' carers across national borders, relating to the cultural relativity of the 'best interest' principle, the availability of family support in different social service structures, the understanding and application of legislation and policy in transnational contexts, and the availability of markers to track and analyse the scale of children crossing borders to join family.

RESUMEN

BACKGROUND: Cultural immersion international learning experiences (CIILEs) are commonly offered in undergraduate nursing education programs worldwide, often with the goal to enhance students' cultural competence. PURPOSE: The purpose of this integrative review was to explore the most recent existing literature concerning the impact of CIILEs on nursing students' cultural competence and to cast a critical eye on the findings. METHOD: We searched the CINAHL database for articles published from 2015 to 2019 and found 30 that met inclusion criteria. RESULTS: The majority of the studies were descriptive or qualitative designs and reported positive overall student cultural competence outcomes. CONCLUSION: The findings support the use of CIILEs with a critical eye for potential negative consequences. The authors recommend further longitudinal, observational studies to identify factors that facilitate substantial long-term positive outcomes.

Asunto(s)

RESUMEN

BACKGROUND: International placements represent a popular choice to develop cultural competency and safety in nursing. The question as to whether study abroad programs enable the development of cultural competency and safety skills or provide exotic travel experiences needs further clarifications. OBJECTIVE: The study explores the usefulness of international placements in developing cultural safety among undergraduate nursing students. DESIGN: An exploratory qualitative design was used to answer these research questions: 1) How do undergraduate students make sense of their study abroad experiences? And 2) How international placements facilitate the acquisition of cultural safety and consciousness-raising about racial and social privileges? PARTICIPANTS: A sample of 7 participants who completed a 4th-year community and acute care stages in Global South countries were recruited. METHODS: A postcolonial feminist theoretical approach was used to guide the study. DATA COLLECTION: Semi-structured interviews explored participants' perceptions of cultural differences, ways of adapting to cultural diversity, and the benefits and challenges of their global experiences. Thematic content analysis was used to analyze the data. RESULTS: Thematic analysis revealed three themes: 1) Self-knowledge, 2) othering, and 3) consciousness of neocolonialism. DISCUSSION: Results raise some concerns about the usefulness of international stages in developing cultural competency and cultural safety in undergraduate nursing students. Results indicate that international placements can be useful to raise consciousness about racial and social privileges. Yet, international placements involve some risks to the receiving Global South countries. This study unmasks Othering's processes, where participants reproduce harmful neocolonial relations. CONCLUSIONS: International placements involve cultural risks that translate into Othering processes where Global South nurses and students are represented as powerless. Postcolonial feminist theories are relevant to study international placements as they enable the critical examination of race, gender, and social class and how they play out in international placements in Global South countries.

Asunto(s)

RESUMEN

INTRODUCTION: International placements challenge students to find the right level of participation, as local practices, language and time pressure may affect their engagement in patient-related tasks or team activities. This study sought to unpack the initiation process during international clinical placements with the ultimate aim to achieve active student participation. METHODS: Following a constructivist grounded theory approach, we conducted two individual interviews with 15 undergraduate healthcare students (before departure and whilst on placement). To identify emerging themes, we applied an iterative process of data collection and constant comparative analysis. Several team discussions informed further analysis, allowing us to reach a more conceptual level of theory. RESULTS: From our findings we constructed a four-phase model of healthcare students' initiation of international clinical placements, which brings into focus how the phases of 'orientation', 'adjustment' and 'contribution to patient care' build up towards a 'sense of belonging'. We identified several factors that induced active student participation in practice, such as a favourable workplace setting, opportunities for learning and a local support network. DISCUSSION: Active student participation is aimed at different goals, depending on the four phases of initiation that eventually lead to a sense of belonging and support workplace learning.

Asunto(s)

RESUMEN

OBJECTIVE: The development and pilot of a self-report questionnaire, to assess personal and professional development of healthcare professionals gained through experiences in low-income and middle-income countries. DESIGN: The instrument was developed from a core set of the outcomes of international placements for UK healthcare professionals. Principal component analysis and multidimensional item response theory were conducted using results of a cross-sectional pilot study to highlight items with the best psychometric properties. SETTING: Questionnaires were completed both online and in multiple UK healthcare professional events face-to-face. PARTICIPANTS: 436 healthcare professional participants from the UK (with and without international experience) completed a 110-item questionnaire in which they assessed their knowledge, skills and attitudes. MEASURES: The 110-item questionnaire included self-report questions on a 7-point Likert scale of agreement, developed from the core outcome set, including items on satisfaction, clinical skills, communication and other important healthcare professional knowledge, skills, attitudes and behaviours. Item reduction led to development of the 40-item Measuring the Outcomes of Volunteering for Education-Tool. Internal consistency was evaluated by the Cronbach's α coefficient. Exploratory analysis investigated the structure of the data using principal component analysis and multivariate item response theory. RESULTS: Exploratory analysis found 10 principal components that explained 71.80% of the variance. Components were labelled 'attitude to work, adaptability, adapting communication, cultural sensitivity, difficult communication, confidence, teaching, management, behaviour change and life satisfaction'. Internal consistency was acceptable for the identified components (α=0.72-0.86). CONCLUSIONS: A 40-item self-report questionnaire developed from a core outcome set for personal and professional development from international placements was developed, with evidence of good reliability and validity. This questionnaire will increase understanding of impact of international placements, facilitating comparisons of different types of experience. This will aid decision making about whether UK healthcare professionals should be encouraged to volunteer internationally and in what capacity.

Asunto(s)

RESUMEN

BACKGROUND: Qualitative narrative analysis and case studies form the majority of the current peer-reviewed literature about the benefits of professional volunteering or international placements for healthcare professionals. These often describe generalised outcomes that are difficult to define or have multiple meanings (such as 'communication skills' or 'leadership') and are therefore difficult to measure. However, there is an interest from employers, professional groups and individual volunteers in generating metrics for monitoring personal and professional development of volunteers and comparing different volunteering experiences in terms of their impact on the volunteers. In this paper, we describe two studies in which we (a) consolidated qualitative research and individual accounts into a core outcome set and (b) tested the core outcome set in a large group of global health stakeholders. METHOD: We conducted a systematic review and meta-synthesis of literature to extract outcomes of international placements and variables that may affect these outcomes. We presented these outcomes to 58 stakeholders in global health, employing a Delphi method to reach consensus about which were 'core' and which were likely to be developed through international volunteering. RESULTS: The systematic review of 55 papers generated 133 unique outcomes and 34 potential variables. One hundred fifty-six statements were then presented to the Delphi stakeholders, of which they agreed 116 were core to a wide variety of healthcare professional practice and likely to be developed through international experiences. The core outcomes (COs) were both negative and positive and included skills, knowledge, attitudes and outcomes for healthcare organisations. CONCLUSIONS: We summarised existing literature and stakeholder opinion into a core outcome set of 116 items that are core to healthcare professional practice and likely to be developed through international experiences. We identified, in the literature, a set of variables that could affect learning outcomes. The core outcome set will be used in a future study to develop a psychometric assessment tool.

Asunto(s)

RESUMEN

Practical examples of the steps involved in the planning and execution of the multiple sorting task are frequently lacking in published reports. This article demonstrates how the multiple sorting task can be used to structure conversations with a group of health professionals planning an international placement for nursing students. Sixteen participants were drawn from diverse professional backgrounds, including academia, clinical practice, government policy, and placement administrators. Participants sorted 17 statements written on cards into categories of their choice and noted why they sorted the cards into these particular groups. Data were analysed using multidimensional scaling and qualitative perspectives. The analysis identified four key themes that detailed the participants' views about international placements. These findings demonstrate how the multiple sorting task can be used to generate information that facilitates the examination of important facets of health care practice that universities could cover in preparing students for international placements.

Asunto(s)

RESUMEN

BACKGROUND: universities in the United Kingdom are being challenged to modify policies and curricula that reflect the changing global reality through internationalisation. An aspect of internationalisation is study abroad which the European Commission Erasmus exchange programme is just one means of addressing this. OBJECTIVE: to explore the experiences of student midwives who are engaged in the Erasmus exchange programme and the effect it has on their learning and working in an international context. DESIGN: approval for the small phenomenological cohort study was obtained from two participating universities: the University of Malta and University of Nottingham. Data were collected from 13 student midwives from a total of five cohorts in the form of diaries to explore their experiences of learning and working in another country. Thematic analysis supported by Computer-Assisted Qualitative Data Analysis Software was used to identify five recurrent themes emerging from the data: the findings of which have served further in developing this programme. FINDINGS: students valued the opportunity of undertaking study and midwifery practice in another culture and healthcare system, extending their knowledge and development of clinical competence and confidence. For some, this was the first time outside of their home country and adaptation to a new environment took time. Support from their contemporaries, lecturers and midwife mentors however, was overwhelmingly positive, enabling the students to feel 'part of the local university / midwifery team' By the end of the programme, the students recognised that they had become more independent and felt empowered to facilitate developments in practice when they returned home. IMPLICATIONS FOR EDUCATION / PRACTICE: this innovative development embracing internationalisation within the curricula has the potential to increase students' employability and further study within Europe and beyond. It can be used as a vehicle to share best practice within an international context, ultimately making a difference to the quality of care childbearing women, their babies and families experience worldwide.

Asunto(s)