Education and Education and Competencies for Competencies for

International Collaborators International Collaborators in Nursing and Midwiferyin Nursing and Midwifery

Junko Tashiro, RN, PhDJunko Tashiro, RN, PhDWHO Collaborating Center for Nursing in PHC WHO Collaborating Center for Nursing in PHC St. Luke’s College of Nursing, Tokyo, JapanSt. Luke’s College of Nursing, Tokyo, Japan

August 6th 2009August 6th 2009

The 24The 24thth Conference of the JAIH at Conference of the JAIH at SendaiSendaiWorkshop: Workshop: Development of International Health Development of International Health ExpertsExperts

22

St. Luke's College of Nursing, St. Luke's College of Nursing, Main Building in Tokyo JapanMain Building in Tokyo Japan

Greetings from Greetings from St. Luke’s College of NursingSt. Luke’s College of Nursing

ContentsContents

To overview our work on capacity To overview our work on capacity development of Japanese nurses development of Japanese nurses collaborating with partners in host collaborating with partners in host countries countries

To share our experience on To share our experience on developing a curriculum of Master developing a curriculum of Master Program for Global Health Nursing to Program for Global Health Nursing to build capacity of Japanese nurse build capacity of Japanese nurse collaborators working with partners collaborators working with partners in host countries based on our studiesin host countries based on our studies

How does Nursing Education in How does Nursing Education in Japan obtain Goals of Global Japan obtain Goals of Global

Health?Health? Emerging an area of “Global or International Health Emerging an area of “Global or International Health

Nursing & Midwifery”Nursing & Midwifery” - - 1960’s1960’s : :Japanese nurses began working for develop-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). --19961996 : : Regulation of Basic Nursing Education enacted: Regulation of Basic Nursing Education enacted: BSN programs started “International nursing”.BSN programs started “International nursing”. --2009 : 2009 : Revised Regulation of Basic Nursing Education : 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”

Current Situation of Higher Current Situation of Higher Education in Global Health or Education in Global Health or

International Nursing and International Nursing and

MidwiferyMidwifery Based on Web-based survey Based on Web-based survey (Tashiro et al, 2008)(Tashiro et al, 2008) Some kind of “Global Health or International Nursing” iSome kind of “Global Health or International Nursing” i

s provided s provided 67(40%) out of the 168 baccalaureate nursing progra67(40%) out of the 168 baccalaureate nursing progra

msms 16(15%) out of the 104 master’s programs16(15%) out of the 104 master’s programs 3 out of the 4 midwifery master programs3 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 Nu2008: International or Global Health Midwifery and Nursing Consortium was formedrsing Consortium was formed

Designing a Curriculum Designing a Curriculum for for

an International Nursing an International Nursing Master’s of Science in Master’s of Science in

Japan:Japan: Capacity Building for International Capacity Building for International

Collaborators to Strengthen Nursing and Collaborators to Strengthen Nursing and MidwiferyMidwifery

WHO Collaborating Center for Nursing in PHCWHO Collaborating Center for Nursing in PHCSt. Luke’s College of Nursing, Tokyo, JapanSt. Luke’s College of Nursing, Tokyo, JapanJunko Tashiro,RN PhD; Naoko Hayashi, RN, PhD; Fumiko Kajii, RN, Junko Tashiro,RN PhD; Naoko Hayashi, RN, PhD; Fumiko Kajii, RN, PhD; Yoshimi Yamazaki, RN, MNS; Akiko Hayashi, RN, MS; Hiromi PhD; Yoshimi Yamazaki, RN, MNS; Akiko Hayashi, RN, MS; Hiromi Eto, RN, CNM, DNSc; Yumi Sakyo, RN, MNS; Shigeko Horiuchi, RN, Eto, RN, CNM, DNSc; Yumi Sakyo, RN, MNS; Shigeko Horiuchi, RN, CNM, DNSc.CNM, DNSc.

Funded by a Grant for International Medical Cooperation Study, Funded by a Grant for International Medical Cooperation Study, International Medical Center in Japan International Medical Center in Japan (2002~2004)(2002~2004)

BackgroundBackground Japanese nurses have cooperated Japanese nurses have cooperated

with their counter-parts in developing with their counter-parts in developing countries since 1960. countries since 1960.

Today number of Japanese nurses & Today number of Japanese nurses & nurse-midwives are working in order nurse-midwives are working in order to strengthen nursing & Midwifery in to strengthen nursing & Midwifery in developing countriesdeveloping countries

Limited opportunities existed for Limited opportunities existed for advanced education as a specialist advanced education as a specialist collaborator in Global Health or collaborator in Global Health or International Nursing. International Nursing.

Purpose Purpose

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

MethodMethod First Phase: First Phase: Study the existing Study the existing

competencies of Nurse International competencies of Nurse International CollaboratorsCollaborators

Data collection: Data collection: Interview surveyInterview 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:Analysis: Content analysis Content analysis Second PhaseSecond Phase:: Curriculum DevelopmentCurriculum Development A conceptual framework of “International A conceptual framework of “International

Nursing Collaboration” was derived from the Nursing Collaboration” was derived from the data. data.

FindingsFindings Snow-ball sampling technique located Snow-ball sampling technique located

twenty-six (26) nurses who were twenty-six (26) nurses who were interviewed interviewed

39 categories of competences were 39 categories of competences were derived from interview data. derived from interview data.

2 major types of categories: 2 major types of categories: personal personal and basicand basic knowledge and knowledge and competenciescompetencies and and international international collaborating competences.collaborating competences.

They were organized into 4 levels of They were organized into 4 levels of education: undergraduate, education: undergraduate, continuing-ed, graduate-masters, and continuing-ed, graduate-masters, and graduate-doctoral level of education.graduate-doctoral level of education.

Fig. Competencies of International Nursing Collaborator and Educational Programs

Factors inf lue ncin g Col lab oration Factors inf lue ncin g Col lab oration

Host country

Social Status & Situation of Nursing

Cultural/ Economical/Social Situation

Both Organization

Relationship with Other Agencies and Projects

Activiti es of Coll ab oration Ta sk

Activ ities

Japan

Cultural/ Economical/Social Situation

Collecting InformationAssessment NetworkingPlanningImplementingProblem AnalysisProblem Solving SpecialtyKnowledge ofGlobal Health and NursingPersonal competenciesCultural Understanding &

AdaptationApplicability

Language & Communication

Compete ncies Educational Programs

Social Status & Situation of Nursing

NursingArea ＆ Levels

Governmental

Organizational

Team

Individual

Policy making

Administration

Clinical

Nursing education

Community

Professionalorganization

From preparation To planning

Implementation

Evaluation

A A Model of Competencies of Model of Competencies of International Nursing Collaborators International Nursing Collaborators

(Experts )(Experts )　　

Competencies and Competencies and Educational Content for Educational Content for UndergraduatesUndergraduates

Personal & Basic Knowledge Personal & Basic Knowledge Educational Educational Content &Competencies Content &Competencies

Cultural AdaptabilityCultural Adaptability

ApplicabilityApplicability

Language & Language &

Communication SkillCommunication Skill

Basic knowledge of Basic knowledge of

International NursingInternational Nursing

Cultural Cultural ExperienceExperience

Language and Language and

CommunicationCommunication

Introduction of Introduction of

InternationalInternational NursingNursing

Data-Driven Competencies for Data-Driven Competencies for

International Nursing CollaboratorInternational Nursing Collaborator Information gathering Information gathering Problem AnalysisProblem Analysis PlanningPlanning Problem SolvingProblem Solving ManagementManagement NetworkingNetworking EvaluationEvaluation

Curriculum for Global Health Curriculum for Global Health Nursing in Master’s ProgramNursing in Master’s Program

Educational Aim :Educational Aim : To provide students with the To provide students with the

basic skills to serve as leaders basic skills to serve as leaders in the nursing field in “Global in the nursing field in “Global Health”, adding knowledge Health”, adding knowledge and skills in international and skills in international public health medical services public health medical services to their own specialist nursing to their own specialist nursing abilities. abilities.

Learning Objectives of Master Learning Objectives of Master

in Global Health Nursingin 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.

Continued - Learning Continued - Learning ObjectivesObjectives

c) c) to build collaborative relationships with local to build collaborative relationships with local counterparts, forming a practical model, and counterparts, forming a practical model, and serving as a consultant and educatorserving as a consultant and educator

d) to use human and material resources to set d) to use human and material resources to set directions in development and problem directions in development and problem solving to achieve goalssolving to achieve goals

e) to evaluate the results of international e) to evaluate the results of international nursing collaborative projectsnursing collaborative projects

f) to assist in nursing development using f) to assist in nursing development using methods unique to the counterpart nationmethods unique to the counterpart nation

Core Courses Core Courses (6 Credit (6 Credit hours)hours)

Introduction to international Introduction to international nursing (2)nursing (2)

International nursing collaboration International nursing collaboration (2)(2)

Comparative nursing research (2)Comparative nursing research (2)

Elective Courses (6 Elective Courses (6 credits)credits)

Comparative nursing policy making (2) Comparative nursing policy making (2) Comparative community health & Comparative community health &

nursing (2) 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 Comparative nursing research

collaboration (2) collaboration (2)

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 S

ubjects (12)

Progress of Master’s Progress of Master’s Program Program

in Global Health Nursingin Global Health Nursing Our Master’s program in Global Health Our Master’s program in Global Health

Nursing started in 2005, and two Nursing started in 2005, and two students were enrolled. students were enrolled.

Last three years, total of four Last three years, total of four graduates completed the program, and graduates completed the program, and two are working as International two are working as International Collaborators in Tanzania and Collaborators in Tanzania and Indonesia.Indonesia.

Further development is needed to Further development is needed to meet educational needs of nurses and meet educational needs of nurses and midwives working for Improvement of midwives working for Improvement of Global Health Global Health

AcknowledgementsAcknowledgements

We wish acknowledge advisors: Dr. William HolzeWe wish acknowledge advisors: Dr. William Holzemer, Dr. Caroline White, Dr. Beverly McElmurry; amer, Dr. Caroline White, Dr. Beverly McElmurry; and our English editor. Dr. Sarah Porter.nd our English editor. Dr. Sarah Porter.

We also acknowledge our previous research memWe also acknowledge our previous research members: Prof. Michiko Hishinuma, Dr. Naoko Arimorbers: Prof. Michiko Hishinuma, Dr. Naoko Arimori, Masako Sakai, RN, MNS; Yuko Hirabayashi, Ri, Masako Sakai, RN, MNS; Yuko Hirabayashi, RN, MNS. N, MNS.

This study was funded by a Grant for InternationaThis study was funded by a Grant for International Medical Cooperation, National International Mel Medical Cooperation, National International Medical Center in Japan, Ministry of Health and Labdical Center in Japan, Ministry of Health and Labor in Japan or in Japan