east meets west: the partnership experience with overseas/local students in their workplace
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East meets West: The partnership experience with overseas/local students in their workplace. Ms Sharon Cheung & Ms Sandra Pun School of Nursing, The Hong Kong Polytechnic University. Exchange Programme/Overseas Clinical Placement. - PowerPoint PPT PresentationTRANSCRIPT
East meets West: The partnership experience with
overseas/local students in their workplace
Ms Sharon Cheung & Ms Sandra PunSchool of Nursing,
The Hong Kong Polytechnic University
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Exchange Exchange Programme/Overseas Programme/Overseas
Clinical PlacementClinical Placement
Year Number of students Location
1998 31 Chinese Mainland Overseas countries
2000 63 29 out of 63 students participated in a study tour in Hawaii, USA
2005 139 107 to mainland (20 to Henan) 6 to Thailand 20 to UK & Australia 6 outbound exchange to Australia
The programme was introduced by the School of Nursing from 1998 with increasing no. of students recruited
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Aims of student Aims of student exchange/exchange/overseas clinical overseas clinical
placementplacement Provide exposure to overseas nursing experience
Enrich the clinical experience through participation in the patient care and observation from delivered care
Develop understanding of overseas health care system
Further develop students’ ability to communicate with people of other culture and ethnic groups
Acquire an understanding of the trend and development of health care services in that country
Gain professional and life experience in a different culture.
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Exchange programmeExchange programme Aims:
provide opportunity for students to enhance cultural and knowledge exchange during overseas studying/placement
offered the exposure to a global dimension to student’s university life and personal or professional development
Development on three aspects: Enhance intellectual development increased global understanding Enhance personal development(Thompson, Boore & Deeny, 2000)
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Background of the studyBackground of the study
Past studies highlighted- Positive aspects of the learning experience Personal growth of exchange students(Grant & Mchenna, 2003)
Few of them described- Clinical practice experience Problems encountered by students with exchange placement a
mong western countries. Explore the difficulties that students might encounter Strategies students used to deal with the encountered problem
s during placement None of these studies explored-
the exchange experience of nursing students between the Western and Asian countries in their workplace
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Aims of the studyAims of the study Understand the actual learning process Understand the exchange experience of nursin
g students from these countries. Allows the local nursing students to share their
partnership experience with overseas students Explore the mentorship experience of local men
tors with both inbound and local students Students who would like to join the programme will be b
etter informed and prepared for their exchange
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ObjectivesObjectives To understand the expectations and objectives of
exchange students prior to their departure To explore the learning experiences of exchange
students (including inbound, outbound & local students) To identify any difficulties that the exchange students
might encounter during the exchange programme and explore their strategies to overcome these difficulties
To explore students’ post experience reflection on the exchange programme
To describe the partnership experience of local/overseas students during their clinical placement
To identify effective teaching strategies and the benefits of the exchange programme from local mentors’ perspective
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Design of the studyDesign of the study A descriptive/exploratory approach: Investigate the experience of students & mentors participated in the ove
rseas exchange programme
A phenomenological approach: to explore the lived experience gives meaning to each person’s perception of a particular phenomen
on (Polit, Beck & Hungler, 2001)
Main sources of data: The in-depth conversations from the researcher and informant as the
full co-participant. The informants was asked to describe their lived experiences witho
ut leading the discussion
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Sample recruitmentSample recruitment Subjects in this study:
Students and local mentors who had undertaken/partnership experience with the exchange programme at the School of Nursing, the Hong Kong Polytechnic University in academic year 2004 & 2005 (Both inbound and outbound exchange)
Number of exchange students/local mentors recruited
Participated programme
12 6 --- inbound exchange students6 --- outbound exchange students
8 Local students had clinical placement with inbound students
3 Local clinical mentors supervising inbound & local students in a group (> 4 weeks)
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Data CollectionData Collection •Ethnical approval was obtained prior to study
•An information sheet and consent form was given to the selected participants for their consent to participate in the study
Methods to collect data:•Group interviews and/or individual interviews (A semi-structured questionnaire was used as an interview guide)•Students’ learning objectives prior to their departure of home country•Reflective journal during overseas placement & their expectations of the programme•Post-experience reflective journal upon completion of programme
Remarks: Callister (cited in Grant & McKenne, 2002) highlighted the benefit of journal writing - can allow students to release their emotions and feelings about clinical experience.
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Data AnalysisData Analysis By categorization scheme:
Classify and index the materials in order to facilitate further retrieval and review.
Collected data was transcribed into word processing document
The data further converted into smaller and manageable units
Coding schemes was used with clear named category
Researchers meetings: Review the contents of the narrative data.
Results of data analysis were sent back to participants for clarification and ensuring accuracy
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Framework for data analysisFramework for data analysis Before the start of exchange Learning objectivesStudents’ preparationStudents’ feeling about the exchange programme
After completion of exchange programme Professional developmentDifficulties encounteredStrategies used to overcome these difficulties
Partnership experience with local students & supervisors
Recommendations from students and supervisors
Mentorship experience of local supervisors
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Learning objectives for exchange clinical placement
Inbound exchange students(from UK and Australia)
Outbound exchange students (to Victoria University)
Professional context
Expose to different clinical setting in other countryImprove various clinical skillsTry to look after 3-4 patients independentlyensure safetyLearning attitudes: -learn actively -making effort to learnDeal with language barrierWant to make good impressionTry to do best: -work harder -listen to mentor, patientGain personal goals
expose to different health care system being able to know the common diseases more familiar with case managementLearn to be independent & open-minded
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Preparation before exchange Inbound exchange students Outbound exchange students
Personal context
Search information on:UniversityHospitalGovernment – health care systemCommon diseases in HK – SARS, FluOther tourist information
packing luggageSearching information about Melbourne and VUSearching emergency contact no. in Melbourne, with university contact personJoin English activities (Big mouth corner)Watch TV (Pearl)
Professional context
(not mentioned) drug knowledge Focus on geriatric and pediatric areacommunication skill with kidsPractice in laboratorySearch information on the web about health care system Review study materialsReview subject contents & syllabus of clinical practice
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Feelings before exchangeInbound exchange students
Outbound exchange students
Local students (partnership with inbound students)
Worry about communication skills (language barrier)
Worry due to uncertainty but eased by setting learning objectives
Difficult to pack luggage, afraid of missing necessary items
The Leader decision making required to raise questions to coordinator for groupmates
Feel happy, excitedLearn from nursing students from different culture Looking forward, positive for the chance of working with exchange studentsFeel worried about communications skill but solved by speaking moreAble to meet new friends from other countriesExperience stress (New partners from overseas)
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Professional development after the completion of exchange program
Inbound exchange students
Outbound exchange students
Local students (partnership with inbound students)
Professional context
Clinical skills improvedActive application of TPC approach in nursing careUnderstand HK epidemic – Infection control More competent How to prepare for RN related their own preferenceMore reflection on learningPromoting Chinese health practice –Tai ChiGood working relationship with patient, team, students, supervisor (Appreciate group dynamics)
More competent with TPC and active on learning and seeking helpLearn to provide holistic care (know and practice more about Total patient care) More communication with patients trustful relationship with nurses, patients(being treated as team member in ward)More competent with spoken English
Experience different practiceMore competent, efficient in working Learn from inbound students (learning & professional attitude)More communication with patients Improvement in :-Clinical skills-Use of medical terms
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Personal development after completion of exchange program
Inbound exchange students
Outbound exchange students
Local students (partnership with inbound students)
Personal context
Leadership skillsBeing more observant, become more independentMake new friends
Culture exchangeMake new friends Time management skills improvedRecognized self strength & weaknessInterpersonal skills improved
improve spoken English Insight of students: - set goals for personal development e.g. participate in volunteer activitiesMore consideration on future developmentMake new friendsBeing more flexible
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Difficulties encountered during placement
Inbound exchange students
Outbound exchange students
Local students (partnership with inbound students)
Differences between overseas and local clinical practice e.g. aseptic technique for wound dressing Language barrier with Chinese patients-Rotation of supervisor-Stressful with assessment/evaluation(final year students)
Not competent to care unstable patientsBuddy nurse didn’t understand students’ ability (due to different training systems)Fail to communicate with mentor (misunderstanding)Building a trustful relationship with mentorsHome sicknessAdaptation on lifestyleLow competence of spoken English Not many resource in hospital library for case presentation
Patients’ unwilling to receive care from foreign studentsLanguage: fast speakingDifferent Culture
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Strategies to overcome difficulties encountered
Inbound exchange students
Differences of practice -Listen to the advice and understand rationales behind, appreciate the benefit and apply with principles (Not to obey and just follow)Language barrier with Chinese patients - use simple Cantonese for greeting, aided by written tools and body language, seek help from local students for translation, have eye-contact, smile
Outbound exchange students
Misunderstanding with mentors-Seek opportunity actively on how to improve communication skillsLacking of communication with mentors-Seek advice from buddy nurse for improvement
Local students (partnership with inbound students)
Adapt to their spoken English-Ask them to speak slowly and listen attentively-Ask other classmates for translation
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Comments from studentsComment from Inbound exchange students on HK local students
Comments from outbound exchange students on foreign students
Comments from Local students on inbound students
HK local students are:-More “obedient”, not to speak out -passive-Friendly-Welcoming behavior-Helpful-Willing to share feelings of taking care patients
Foreign students are:-Good time management
- they did not have many opportunities to work with foreign students
Overseas students are:-Able to practise holistic care-Confident-More knowledgeable-Active in learning -Eager to teach and share knowledge & experience-Friendly, open, sincere-Few of them were unwilling to try using simple Chinese language to communicate with patients affect nurse-client relationship
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Comments on arrangement of the exchange programme
Inbound exchange students
Outbound exchange students
Local students (partnership with inbound students)
PositiveEnjoyed the placementEnhanced personal and professional developmentWould like to have opportunity to participate in more extra-curricular activitiesWill recommend the program to fellow studentsAECO is helpful on arrangement, with good service and adequate informationGood briefing done by coordinator in HK
PositiveRecommend to stay in accommodation with local students or staff (enhance cultural exchange)
PositiveLonger duration of partnership was advisedPrefer working with inbound students at same year of study Role of supervisor:-Balance on work-arrangement
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Recommendations to student who would like to join the exchange programme
Inbound exchange students
Outbound exchange students
Local students (partnership with inbound students)
Well-organized for the tripSet realistic expectationJoin the programme with open-mindNeed to taste and try, to get valuable experienceBeing more flexiblePrepare for cultural shock
Equip with knowledgeCollect and utilize different kinds of resourcesBe more active, clarify with different parties e.g. nurse, supervisor, local students
-Precious experience-Open to share experience
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Comments on mentorshipInbound exchange students
Outbound exchange students
Local students (partnership with inbound students)
Calm, observant, approachable, teaches, explains gentlySet high expectation Give positive reinforcement to students Discussion freelyMake sure to assign students for translationReceive care from mentorsPost-conference is useful
SupportiveFacilitate learning Arrange different visit to various unitsReceived care from mentorsMore freedom given by supervisorTrustful relationship
Provide more practice opportunity to exchange students (refer to one mentor only)
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Partnership experience from Partnership experience from mentors’ perspectivesmentors’ perspectives
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Focus group interview of Focus group interview of mentorsmentors
To explore & identify: Mentors’ role and teaching experience Professional and personal development
of both inbound and local students as perceived by mentors
Feedback on how to improve the exchange programme
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Results- main themesResults- main themes Role of mentors:
communicators, facilitators, supervisors, resource persons
Teaching experience: All mentors felt challenging with positive attitude
towards supervising inbound and local students in a group
All mentors addressed the importance of understanding the differences between overseas and local practices, extra effort was put into helping inbound students understand & learn about local practice
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PPD of Students PPD of Students (from mentors’ perspective)(from mentors’ perspective)
Local students Inbound studentsLearn more about overseas practices (e.g. holistic care)
Cultural adaptation- learn more about Chinese culture, local policies & practice
Clinical, communication & presentation skills in English improved
Communication skills with Chinese patients improved (e.g. using body language)
Interpersonal skill enhanced (having good relationship with inbound students)
Interpersonal skill enhanced (having good relationship with local students, mentors and ward staff)
More active in learning Self initiation to learn & seek opportunities to practise holistic care
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Feedback on how to improve Feedback on how to improve the programmethe programme
Provide more background information of inbound students to mentors before starting the placement (e.g. course outline, clinical experience)
Suggest mentors (supervising inbound students) to share their teaching experience with colleagues who may have chances to supervise inbound students
Allocate inbound students to mentors with overseas experience or experience of supervising overseas students
Suggest the ratio of inbound to local student as 1:5 or 2:4 and not more than 6 students /clinical group
Would be better to allocate inbound students to clinical group with less AT/AOM assessment
Similar year of study for inbound & local students
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Evaluation of the programme Evaluation of the programme (aims achieved)(aims achieved)
Provide exposure to overseas nursing experience
Enrich the clinical experience through participation in the patient care and observation from delivered care
Develop understanding of overseas health care system
Further develop students’ ability to communicate with people of other culture and ethnic groups
Acquire an understanding of the trend and development of health care services in that country
Gain professional and life experience in a different culture.
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Inbound exchange students froInbound exchange students from Huddersfield University (UK)m Huddersfield University (UK)
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Inbound exchange students Inbound exchange students from Victoria University from Victoria University
(Australia)(Australia)
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AcknowledgementAcknowledgement This study is funded by SLTC of SN at the
Hong Kong Polytechnic University Special thanks to overseas and local
students, and local supervisors for their sharing of experience
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Thank You!Thank You!
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ReferencesReferencesGrant, E., & Mckenna, L. (2003). International clin
ical placement for undergraduate students. Journal of Clinical Nursing, 12(4), 529-535.
Polit, D.F., Beck, C.T., & Hungler, B.P. (2001). Essentials of Nursing Research: Methods, Appraisal, and Utilization (5th ed.). Philadelphia: Lippinocott.
Thompson, K., Boore, J., & Deeny, P. (2000). A comparison of an international experience for nursing students in developed and developing countries. International Journal of Nursing Studies, 37, 481-492.