International cultural immersion: En vivo reflections in cultural competence

Background: Health disparities for ethnic minority groups are increasing despite effective population-based interventions. Culturally competent health care can bridge social inequalities that limit gains in health outcomes by ethnic minorities. A baccalaureate nursing program developed and implemented an international cultural immersion program in Guatemala to explore the impact of cultural immersion on student nurses' cultural competence. Key components of the course were intensive Spanish language lessons, community health service learning projects, and a research design to evaluate short term and long term student outcomes. Methods: This qualitative descriptive study generated data through in-depth interviews prior to leaving for Guatemala and en vivo reflective journals while in Guatemala. Between 2008 and 2009, twenty-eight undergraduate nursing students participated in the study. Results: The three themes that emerged were: Navigating daily life, Broadening the lens, and Making a difference. En vivo reflections of daily life in Guatemala revealed a larger context and worldview of culture, as well as the role students played in social and professional interactions with immigrant populations. Conclusions: International service learning seemed to pervade all aspects of the students' experience, from conducting an outreach clinic to living with host families. Gaining language skills was integral to these activities. Exercises in participant-observation and reflective writing in the nursing curriculum could enhance student self-awareness and their ability to benefit from a cultural immersion course.