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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.

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Presentation on theme: "East meets West: The partnership experience with overseas/local students in their workplace Ms Sharon Cheung & Ms Sandra Pun School of Nursing, The Hong."— Presentation transcript:

1 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

2 2 Exchange Programme/Overseas Clinical Placement YearNumber of studentsLocation 199831  Chinese Mainland  Overseas countries 200063  29 out of 63 students participated in a study tour in Hawaii, USA 2005139  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

3 3 Aims of student exchange/overseas clinical placement  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.

4 4 Exchange 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)

5 5 Background 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 among western countries.  Explore the difficulties that students might encounter  Strategies students used to deal with the encountered problems during placement  None of these studies explored-  the exchange experience of nursing students between the Western and Asian countries in their workplace

6 6 Aims of the study  Understand the actual learning process  Understand the exchange experience of nursing students from these countries.  Allows the local nursing students to share their partnership experience with overseas students  Explore the mentorship experience of local mentors with both inbound and local students  Students who would like to join the programme will be better informed and prepared for their exchange

7 7 Objectives  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

8 8 Design of the study A descriptive/exploratory approach:  Investigate the experience of students & mentors participated in the overseas exchange programme A phenomenological approach:  to explore the lived experience  gives meaning to each person’s perception of a particular phenomenon (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 without leading the discussion

9 9 Sample 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 126 --- inbound exchange students 6 --- outbound exchange students 8Local students had clinical placement with inbound students 3Local clinical mentors supervising inbound & local students in a group (> 4 weeks)

10 10 Data 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.

11 11 Data 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

12 12 Framework for data analysis  Before the start of exchange  Learning objectives  Students’ preparation  Students’ feeling about the exchange programme  After completion of exchange programme  Professional development  Difficulties encountered  Strategies used to overcome these difficulties  Partnership experience with local students & supervisors  Recommendations from students and supervisors  Mentorship experience of local supervisors

13 13 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 country Improve various clinical skills Try to look after 3-4 patients independently ensure safety Learning attitudes: -learn actively -making effort to learn Deal with language barrier Want to make good impression Try to do best: -work harder -listen to mentor, patient Gain personal goals expose to different health care system being able to know the common diseases more familiar with case management Learn to be independent & open- minded

14 14 Preparation before exchange Inbound exchange studentsOutbound exchange students Personal context Search information on: University Hospital Government – health care system Common diseases in HK – SARS, Flu Other tourist information packing luggage Searching information about Melbourne and VU Searching emergency contact no. in Melbourne, with university contact person Join English activities (Big mouth corner) Watch TV (Pearl) Professional context (not mentioned) drug knowledge Focus on geriatric and pediatric area communication skill with kids Practice in laboratory Search information on the web about health care system Review study materials Review subject contents & syllabus of clinical practice

15 15 Feelings before exchange Inbound 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, excited Learn from nursing students from different culture Looking forward, positive for the chance of working with exchange students Feel worried about communications skill but solved by speaking more Able to meet new friends from other countries Experience stress (New partners from overseas)

16 16 Professional development after the completion of exchange program Inbound exchange students Outbound exchange students Local students (partnership with inbound students) Professional context Clinical skills improved Active application of TPC approach in nursing care Understand HK epidemic – Infection control More competent How to prepare for RN related their own preference More reflection on learning Promoting Chinese health practice –Tai Chi Good working relationship with patient, team, students, supervisor (Appreciate group dynamics) More competent with TPC and active on learning and seeking help Learn 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 practice More competent, efficient in working Learn from inbound students (learning & professional attitude) More communication with patients Improvement in : - Clinical skills - Use of medical terms

17 17 Personal development after completion of exchange program Inbound exchange students Outbound exchange students Local students (partnership with inbound students) Personal context Leadership skills Being more observant, become more independent Make new friends Culture exchange Make new friends Time management skills improved Recognized self strength & weakness Interpersonal skills improved improve spoken English Insight of students: - set goals for personal development  e.g. participate in volunteer activities More consideration on future development Make new friends Being more flexible

18 18 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 patients Buddy nurse didn’t understand students’ ability (due to different training systems) Fail to communicate with mentor (misunderstanding) Building a trustful relationship with mentors Home sickness Adaptation on lifestyle Low competence of spoken English Not many resource in hospital library for case presentation Patients’ unwilling to receive care from foreign students Language: fast speaking Different Culture

19 19 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 skills Lacking 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

20 20 Comments from students Comment 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

21 21 Comments on arrangement of the exchange programme Inbound exchange students Outbound exchange students Local students (partnership with inbound students) Positive Enjoyed the placement Enhanced personal and professional development Would like to have opportunity to participate in more extra-curricular activities Will recommend the program to fellow students AECO is helpful on arrangement, with good service and adequate information Good briefing done by coordinator in HK Positive Recommend to stay in accommodation with local students or staff (enhance cultural exchange) Positive Longer duration of partnership was advised Prefer working with inbound students at same year of study Role of supervisor: - Balance on work - arrangement

22 22 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 trip Set realistic expectation Join the programme with open-mind Need to taste and try, to get valuable experience Being more flexible Prepare for cultural shock Equip with knowledge Collect and utilize different kinds of resources Be more active, clarify with different parties e.g. nurse, supervisor, local students - Precious experience - Open to share experience

23 23 Comments on mentorship Inbound exchange students Outbound exchange students Local students (partnership with inbound students) Calm, observant, approachable, teaches, explains gently Set high expectation Give positive reinforcement to students Discussion freely Make sure to assign students for translation Receive care from mentors Post-conference is useful Supportive Facilitate learning Arrange different visit to various units Received care from mentors More freedom given by supervisor Trustful relationship Provide more practice opportunity to exchange students (refer to one mentor only)

24 24 Partnership experience from mentors’ perspectives

25 25 Focus group interview of mentors  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

26 26 Results- 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

27 27 PPD of Students (from mentors’ perspective) Local studentsInbound students Learn 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 learningSelf initiation to learn & seek opportunities to practise holistic care

28 28 Feedback on how to improve the 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

29 29 Evaluation of the programme (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.

30 30 Inbound exchange students from Huddersfield University (UK)

31 31 Inbound exchange students from Victoria University (Australia)

32 32 Acknowledgement  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

33 33 Thank You!

34 34 References Grant, E., & Mckenna, L. (2003). International clinical 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.


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