1. Education and Competencies for International Collaborators in Nursing and Midwifery Junko Tashiro, RN, PhD WHO Collaborating Center for Nursing in PHC St. Luke’s College of Nursing, Tokyo, Japan St. Luke’s College of Nursing, Tokyo, Japan August 6th 2009 The 24 th Conference of the JAIH at Sendai Workshop: Development of International Health Experts

2. 2 St. Luke's College of Nursing, Main Building in Tokyo Japan Greetings from St. Luke’s College of Nursing St. Luke’s College of Nursing

3. Contents To overview our work on capacity development of Japanese nurses collaborating with partners in host countries To overview our work on capacity development of Japanese nurses collaborating with partners in host countries To share our experience on developing a curriculum of Master Program for Global Health Nursing to build capacity of Japanese nurse collaborators working with partners in host countries based on our studies To share our experience on developing a curriculum of Master Program for Global Health Nursing to build capacity of Japanese nurse collaborators working with partners in host countries based on our studies

4. How does Nursing Education in Japan obtain Goals of Global Health? Emerging an area of “Global or International Health Nursing & Midwifery” Emerging an area of “Global or International Health Nursing & Midwifery” - 1960’s : Japanese nurses began working for develop- - 1960’s : Japanese nurses began working for develop- ment of nursing and health in host countries (Mori,1999). ment of nursing and health in host countries (Mori,1999). - 1996 : Regulation of Basic Nursing Education enacted: - 1996 : Regulation of Basic Nursing Education enacted: BSN programs started “International nursing”. BSN programs started “International nursing”. - 2009 : Revised Regulation of Basic Nursing Education : - 2009 : Revised Regulation of Basic Nursing Education : Diploma Program have to start teaching “International Diploma Program have to start teaching “International Nursing” or “Disaster Nursing” Nursing” or “Disaster Nursing”

5. Current Situation of Higher Education in Global Health or International Nursing and Midwifery Based on Web-based survey (Tashiro et al, 2008) Based on Web-based survey (Tashiro et al, 2008) Some kind of “Global Health or International Nursing” is provided Some kind of “Global Health or International Nursing” is provided 67(40%) out of the 168 baccalaureate nursing programs 67(40%) out of the 168 baccalaureate nursing programs 16(15%) out of the 104 master’s programs 16(15%) out of the 104 master’s programs 3 out of the 4 midwifery master programs 3 out of the 4 midwifery master programs 13 out of the 47 nursing programs 13 out of the 47 nursing programs 2008: International or Global Health Midwifery and Nursing Consortium was formed 2008: International or Global Health Midwifery and Nursing Consortium was formed

6. Designing a Curriculum for an International Nursing Master’s of Science in Japan: Capacity Building for International Collaborators to Strengthen Nursing and Midwifery WHO Collaborating Center for Nursing in PHC St. Luke’s College of Nursing, Tokyo, Japan Junko Tashiro,RN PhD; Naoko Hayashi, RN, PhD; Fumiko Kajii, RN, PhD; Yoshimi Yamazaki, RN, MNS; Akiko Hayashi, RN, MS; Hiromi Eto, RN, CNM, DNSc; Yumi Sakyo, RN, MNS; Shigeko Horiuchi, RN, CNM, DNSc. Funded by a Grant for International Medical Cooperation Study, International Medical Center in Japan (2002~2004)

7. Background Japanese nurses have cooperated with their counter-parts in developing countries since 1960. Japanese nurses have cooperated with their counter-parts in developing countries since 1960. Today number of Japanese nurses & nurse-midwives are working in order to strengthen nursing & Midwifery in developing countries Today number of Japanese nurses & nurse-midwives are working in order to strengthen nursing & Midwifery in developing countries Limited opportunities existed for advanced education as a specialist collaborator in Global Health or International Nursing. Limited opportunities existed for advanced education as a specialist collaborator in Global Health or International Nursing.

8. Purpose To design a specialty of International Nursing in a master’s program in Japan, based on “competencies of international nursing collaborators” for nurses who are interested in working for and in developing countries. To design a specialty of International Nursing in a master’s program in Japan, based on “competencies of international nursing collaborators” for nurses who are interested in working for and in developing countries.

9. Method First Phase: Study the existing competencies of Nurse International Collaborators First Phase: Study the existing competencies of Nurse International Collaborators Data collection: Interview survey Data collection: Interview survey Participants: Participants: Japanese nurses who worked or are Japanese nurses who worked or are working for more than one year in working for more than one year in developing countries to strengthening developing countries to strengthening that country’s nursing and midwifery. that country’s nursing and midwifery. Analysis: Content analysis Analysis: Content analysis Second Phase: Curriculum Development Second Phase: Curriculum Development A conceptual framework of “International Nursing Collaboration” was derived from the data. A conceptual framework of “International Nursing Collaboration” was derived from the data.

10. Findings Snow-ball sampling technique located twenty- six (26) nurses who were interviewed Snow-ball sampling technique located twenty- six (26) nurses who were interviewed 39 categories of competences were derived from interview data. 39 categories of competences were derived from interview data. 2 major types of categories: personal and basic knowledge and competencies and international collaborating competences. 2 major types of categories: personal and basic knowledge and competencies and international collaborating competences. They were organized into 4 levels of education: undergraduate, continuing-ed, graduate- masters, and graduate-doctoral level of education. They were organized into 4 levels of education: undergraduate, continuing-ed, graduate- masters, and graduate-doctoral level of education.

11. A Model of Competencies of International Nursing Collaborators (Experts ) A Model of Competencies of International Nursing Collaborators (Experts )

12. Competencies and Educational Content for Undergraduates Personal & Basic Knowledge Educational Content &Competencies Personal & Basic Knowledge Educational Content &Competencies Cultural Adaptability Applicability Language & Communication Skill Communication Skill Basic knowledge of International Nursing International Nursing Cultural Experience Language and Communication Communication Introduction of International Nursing International Nursing

13. Data-Driven Competencies for International Nursing Collaborator Information gathering Information gathering Problem Analysis Problem Analysis Planning Planning Problem Solving Problem Solving Management Management Networking Networking Evaluation Evaluation

14. Curriculum for Global Health Nursing in Master’s Program Educational Aim : To provide students with the basic skills to serve as leaders in the nursing field in “Global Health”, adding knowledge and skills in international public health medical services to their own specialist nursing abilities. To provide students with the basic skills to serve as leaders in the nursing field in “Global Health”, adding knowledge and skills in international public health medical services to their own specialist nursing abilities.

15. Learning Objectives of Master in Global Health Nursing Increase specialized knowledge of international nursing, based on fundamental skills ( e.g. Language ability, cultural adaptability) Strengthen ability: a) to make an accurate assessment of nursing issue in the specialized field of international cooperation, covering different cultural, socioeconomic, and public health systems. b) to plan cooperation and assistance projects responding to the nursing needs of the counterpart nation.

16. Continued - Learning Objectives c) to build collaborative relationships with local counterparts, forming a practical model, and serving as a consultant and educator d) to use human and material resources to set directions in development and problem solving to achieve goals e) to evaluate the results of international nursing collaborative projects f) to assist in nursing development using methods unique to the counterpart nation

17. Core Courses (6 Credit hours) Introduction to international nursing (2) Introduction to international nursing (2) International nursing collaboration (2) International nursing collaboration (2) Comparative nursing research (2) Comparative nursing research (2)

18. Elective Courses (6 credits) Comparative nursing policy making (2) Comparative nursing policy making (2) Comparative community health & nursing (2) Comparative community health & nursing (2) Comparative nursing education (2) Comparative nursing education (2) Comparative nursing administration (2) Comparative nursing administration (2) Comparative clinical nursing (2) Comparative clinical nursing (2) Comparative nursing research collaboration (2) Comparative nursing research collaboration (2)

19. 2nd Year Thesis Research (8) Practicum (2) 1st Year Nursing management & administration (2) Nursing education (2) Community nursing (2) Clinical nursing (2) Nursing research (2), Nursing theory (2), Statistics (2) Nursing ethics (2), Anatomy & Physiology(2), Pathology(2), Nursing Sociology(2) ， Nursing psychology (2), Elective Minor Courses (6) Comparative nursing policy making (2) Comparative community health and nursing (2) Comparative nursing education (2) Comparative nursing administration (2) Comparative clinical nursing (2) Comparative nursing research collaboration (2) Core Courses (6) Introduction to international nursing (2) International nursing collaboration (2) Comparative nursing research (2) Fig. Global Health Nursing Curriculum Diagram Major fields (12) Basic Subjects (12)

20. Progress of Master’s Program in Global Health Nursing Our Master’s program in Global Health Nursing started in 2005, and two students were enrolled. Our Master’s program in Global Health Nursing started in 2005, and two students were enrolled. Last three years, total of four graduates completed the program, and two are working as International Collaborators in Tanzania and Indonesia. Last three years, total of four graduates completed the program, and two are working as International Collaborators in Tanzania and Indonesia. Further development is needed to meet educational needs of nurses and midwives working for Improvement of Global Health Further development is needed to meet educational needs of nurses and midwives working for Improvement of Global Health

21. Acknowledgements Acknowledgements We wish acknowledge advisors: Dr. William Holzemer, Dr. Caroline White, Dr. Beverly McElmurry; and our English editor. Dr. Sarah Porter. We wish acknowledge advisors: Dr. William Holzemer, Dr. Caroline White, Dr. Beverly McElmurry; and our English editor. Dr. Sarah Porter. We also acknowledge our previous research members: Prof. Michiko Hishinuma, Dr. Naoko Arimori, Masako Sakai, RN, MNS; Yuko Hirabayashi, RN, MNS. We also acknowledge our previous research members: Prof. Michiko Hishinuma, Dr. Naoko Arimori, Masako Sakai, RN, MNS; Yuko Hirabayashi, RN, MNS. This study was funded by a Grant for International Medical Cooperation, National International Medical Center in Japan, Ministry of Health and Labor in Japan This study was funded by a Grant for International Medical Cooperation, National International Medical Center in Japan, Ministry of Health and Labor in Japan