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Internationalisation is becoming part of the vernacular in undergraduate nursing curriculum. One could argue that the transfer of preparatory nursing courses to the university sector has radically changed nursing in that 'universities' have always defined themselves as international institutions. This has led to a significant change in foci as baccalaureate nursing programs become increasingly committed to the notion that international education is a powerful mechanism for internationalising the curriculum, and encouraging a global perspective for nursing. Nursing as a profession is cognizant of the rapid changes in our world, such as increased ethnic diversity and the recognition of nursing internationally as a crucial health care resource: this places increasing demand on international education opportunities. This is the time for nursing education providers to pause and take stock of this aspect of baccalaureate programs, and ask if current curricula meet this demand.
The question of readiness for internalisation forced us to look inwards at our own curriculum. Similar to many providers, the local context dominates in our undergraduate curricula. Using a problem based learning (PBL) approach, however, each practice problem is also considered in a different practice setting than that proposed in the original practice problem, and in different cultural groups. This ensures that students develop the skills to adapt their practice to any context and to develop cultural safety skills. Our PBL scenarios are designed to ensure that issues associated with gender, culture, sexuality and linguistic diversity are considered throughout the program, with supplementation in clinical practice regarding ethical professional practice.
The aim of this study is to explore the context of our own baccalaureate curriculum to assist our teaching staff to evaluate the extent to which the curriculum is internationalised, and to help us as a team to identify, where appropriate, further action is necessary. To achieve this, we administered the Questionnaire on Internationalisation of the Curriculum (QIC) a questionnaire that looks at the context in which the program is taught, as well as individual elements of the curriculum such as content, assessment and teaching and learning processes. The respondents were asked to locate different aspects of their program on a continuum, using some descriptors as a guide. At the end of the questionnaire respondents were asked to locate the program as a whole on a continuum.
In 1986: As we consider the challenge of the AASCU to educators to internationalise curricula, it seems apparent that some schools are indeed responding to this challenge in a variety of creative and exciting ways. It is hoped that by sharing some of these ideas and continuing to study this area, we, as nursing educators, can learn from one another and generate new ideas for the internationalisation of nursing curricula that will help students to develop a global perspective as they prepare to practice in the future.
Cross-cultural communication, global peace, and national security are all current arguments for internationalisation.
Effective internationalisation of nursing education means looking outside one's comfort zone.
- what it is
Although linked, internationalisation and globalization are different phenomena rather than interchangeable terms. Internationalisation is concerned with relationships among and between individual countries, and 'presupposes the nation-state as the essential unit'.
Seen more broadly, international nursing curriculum development can be interpreted as a sanctioned extension of transnational, cross-cultural, political and economic professional outreach activities.
- why is it important?
As the world gets smaller, the demand for internationally oriented, culturally aware nurses grows. Making internationalisation a fundamental pillar in nursing should not be optional but mandatory for the future generation of nurses.
The catalysts for the evolving internationalisation agenda at a macro level, include political and educational policies, at a meso level, professional expectations and a micro level involves an improvement of patient care.
Healthcare consumers are entitled to culturally competent care. Therefore, nursing curricula need to include cultural content and student nurses and faculty members need to be culturally competent.
Developing international curricula could present opportunities for faculty worldwide to establish and build international collegial relationships.
Decisions regarding how we internationalise within nursing will affect our students and international partners both in the short and long term.
With increasing advertising aimed at enticing nurses to take up opportunities overseas, the numbers of nurses either not returning to their own country after completing their studies in Western countries, or leaving to take up a position in a more affluent country is growing. Nurse migration is common.
It is believed that education with its instillation of broad ideals will facilitate world peace. In turn, global citizenship and partnerships that come with increased understanding of the world will resolve global issues such as pollution and terrorism. As well, education undertaken from an international perspective will facilitate professional success and global competence. The desire for and achievement of national dominance in global, political, and economic arenas is associated with internationalisation.
Excellence in nursing education requires the preparation of graduates who are both culturally competent and good global citizens. Internationalisation of faculties of nursing therefore needs to occur in a critically conscious manner with an appraisal of the values underlying our mission statements, programs, and activities.
The concept of internationalising within education is based on economic rationales. These rationales included:
• an emphasis on internationalisation due to the requirements of the modern, more global labour force,
• joint international research and development projects needed to compete globally in new technology, and
• more attention to the marketing of higher education on the international market: higher education as an export commodity.
International nursing student exchanges: Nurturing strategic political relationships as an essential component of an international nursing curriculum development process is also captured in the literature. Comments reflecting the importance of building key collegial relationships within international curriculum development activities are well described. They:
• Ensuring face-to-face opportunities to get to know colleagues in partner countries by scheduling site visits before beginning curriculum development and student exchanges;
• Respecting team member cultural differences;
• Recognizing and learning from diversities, as well as similarities, in nursing practices within the consortium countries;
• Agreeing to common goals early in the relationship building process;
• Communicating within the curriculum development team; and
• Working hard while maintaining a sense of humour (and fun).
Challenges germane to nursing …
the challenges for nurse educators relate to how to deliver educational and practice differences such as diversity, which can enhance contemporary nursing regardless of one's native place and space.
Not all nurses are open to the possibilities that can evolve from working alongside their international colleagues. Part of the problem is the perception that one's home institution is the only or best place and space for nursing education to occur. Inherent within this viewpoint is that cross-cultural experiences and ways of practicing nursing are less valued and perceived as different, and that international nurses are given lower status.
While nurse educators strive to prepare culturally competent nurses who can compete successfully in the local, national, and international marketplace, the values underlying the profession of nursing tend to be humanistic.
Internationalisation offers opportunities. Some of the benefits that could result from internationalisation of nursing include sharing of knowledge, ideas, understandings and research findings.
A further concern is the work readiness of migrant nurses and the capacity of organisations to provide support and training for them. Migrant nurses often face difficulties with language and technology and may be less financially secure and more culturally challenged than those arriving from countries such as the UK and NZ.
Further, universities have become increasingly economically dependent on international full fee paying students and need to balance increases in local numbers with the need to secure funding through international student enrolments and other international initiatives.
Whilst the challenges are enormous, the imperative to internationalise may help to free us from structures that currently constrain us, such as unifocal explanations for health and illness and continued reliance on behaviorist curriculum models.
Success, however, is contingent on collaboration, trust and creating forums for international exchange that are inclusive of multiple perspectives which value multivalent partnerships as positive and productive. Such groups would have moral imperatives as the central concern in decision-making.
How conscious is integration into the curriculum?
Traditionally, academic staff in higher education have focussed on content rather than on process. Changing this emphasis is a major challenge.
Internationalisation of faculties of nursing therefore needs to occur in a critically conscious manner with an appraisal of the values underlying our mission statements, programs, and activities.
how - testing nursing curriculum against the curricula typology defined by in Leask - How does your curriculum measure up??
Defining characteristic for nursing curriculum
Curricula that prepare graduates for defined international professions:
Professional practices in the international environment determine course content and delivery.
Curricula leading to internationally recognized professional qualification ;
Course is recognized by international accrediting bodies.
Successful completion of the course leads to an internationally recognized professional qualification.
Curricula in which compulsory parts are offered at or by universities abroad, staffed by local lecturers(including exchange and study abroad programs):
Part of the course is delivered by another institution in another country. Credit is given for prior learning undertaken offshore.
Interdisciplinary programs, such as region and area studies, covering more than one country:
Course requirements include detailed and extensive international case studies from more than one country and/or real or simulated instances of cross-cultural negotiation and communication. Assessment tests the application of international standards and practices within the profession in different cultural settings.
Curricula in which the traditional or original subject area is broadened by international cross-cultural or intercultural approaches:
Includes specific reference to contemporary international and Australian content. Addresses issues such as social justice, equity, human rights, and related social and economic issues.
Addresses critical global environmental issues.
Includes topics on ethical issues in globalization.
Includes international case studies.
Includes accounts of the historical background to current international practices.
Includes investigation of professional practices in other cultures.
Includes an exploration of how knowledge may be constructed differently from culture to culture in the subject area concerned.
Curricula in which the content is especially designed for overseas students:
Course content and delivery specifically addresses the needs of overseas students in Australia and/or offshore.
The generic indicators for Graduate Quality
A Graduate Who Demonstrates International Perspectives as a Professional Citizen Will . . .
Display an ability to think globally and consider issues from a variety of perspectives.
Demonstrate an awareness of their own culture and its perspectives and other cultures and their perspectives.
Appreciate the relation between their field of study locally and professional traditions elsewhere.
Recognize intercultural issues relevant to their professional practice.
Appreciate the importance of multicultural diversity to professional practice and citizenship.
Appreciate the complex and interacting factors that contribute to notions of culture and cultural relationships.
Value diversity of language and culture.
Appreciate and demonstrate the capacity to apply international standards and practices within the discipline or professional area.
Demonstrate awareness of the implications of local decisions and actions for international communities and of international decisions and actions for local communities.
The improvement of nurses' workplaces and spaces is integrally linked to nurses' avoidance of ethnocentric thinking and practices.
Teaching about, for example, internationalisation in the nurse education programme is supposed to be anchored in students' life experiences. It should also be linked to how the students relate the material to their experience when they have understood and conceptualized the educational content presented.
It also requires increased 'teacher awareness'. It is suggested that when internationalisation is in focus in different learning situations within the nurse education programme, this study's outcome space could be considered in the teaching programme.