Beyond “Study Abroad”: Developing Cultural Humility and Clinical Acumen Through an International Practicum Option for NP Students

Domain 7 of the NONPF core competencies for nurse practitioners addresses the importance of culturally-sensitive care.  Traditionally, this competency has been addressed by incorporation of “cultural competency” materials in NP curricula.  The term cultural competency suggests an endpoint at which a student has achieved the competency.  A more accurate term for this concept is cultural humility, an ongoing process by which a clinician engages in self reflection and inquiry about his or her own culture and the culture of his or her patient.

An ideal opportunity to develop cultural humility is through cultural immersion. While study-abroad options abound, they often take the form of academic tourism and are not well-suited to the learning needs of nurse practitioner students.  In collaboration with a non-for-profit health advocacy organization (Little by Little, Glenview, IL), we designed a clinical rotation option for NP students in Gramothe, Haiti.  

The purpose of this presentation is to describe this planned cultural humility immersion and its outcomes. The rotation includes pre-departure study of Haitian culture and beliefs, management of tropical disease, cultural humility and other preparatory learning.  The learning module is delivered online and followed by a face-to-face meeting.  The clinical rotation entails 40 hours of direct-care and is available to finishing FNP and PNP students. Program evaluation is conducted by both students and clinical faculty.   Students are evaluated by clinical faculty using a clinical evaluation tool keyed to the NONPF competencies.  Student evaluations of the program are done via a structured reflection of the program upon returning.  The presentation will conclude with results of the 2011 NP clinical rotations in Gramothe, Haiti.

Objectives:

At the completion of the presentation, the learner will be able to

1)     Describe the concept of cultural humility and its application in clinical education

2)     Identify opportunities for inclusion of cultural humility training in existing curricula

3)     Identify potential partners for establishing an international clinical practicum option

4)     Identify regulatory requirements to consider before implementing an international practicum option

5)     Begin to plan a curriculum of preparatory learning for an international practicum