A World’s Health Perspective through the Eyes of Online Nursing Students

Author Information
Kimberly Balko, Assistant Professor MS, RN
Jennifer Boisvert, MS
Lisa Rapple, MS. Ed.
Institution(s) or Organization(s) Where EP Occurred: 
SUNY Empire State College
Effective Practice Abstract/Summary
Abstract/Summary of Effective Practice: 

SUNY Empire State College’s RN to BS in nursing program developed an interactive, student led online course called Global Health (NUR-203254). This course allows students to perform research on a selected country and present findings to their classmates. Students learn about the various global health care systems and barriers that contribute to health care disparities. Exposure to global diversity and health care disparities prepares students to reflect on their previously held biases to improve adherence to professional standards of respect and civility, and to become cultural competent, in caring for patients across all health care settings.

Description of the Effective Practice
Description of the Effective Practice: 

In this online course, students examine problems confronting developing countries and integrate the role of the nurse through research, collaboration, and advocacy in the creation of a health promotion educational plan for a vulnerable population. The goal of this course is to introduce nursing students to the field of global health.

Students start by selecting a country from a list that their instructor provides to them. This then allows them to obtain a badge which contains their chosen country’s flag. During the first week of the course they are to read the directions for their final project. Students research and submit information about their country within individual summary posts which include the topics of historical, cultural, health care systems, and health indicators specific to their selected country. Using the summary posts, students share new information with their classmates and instructor. Students have six weeks to finish the readings and videos, and to complete summary posts for their specific country. During the next eight weeks, the learning design is focused  on round-table discussions. The round-table assignment facilitates  and enhances student interaction and student collaboration with each other about specific areas in global health. Areas include nutrition and environmental health, women and children's health, mental health, communicable and non-communicable diseases, natural disasters, and humanitarian emergencies. Students are directed to discuss specific health issues that their country faces, propose solutions that may be viable, respond to at least two classmates, and then as a group they come together as a community of learners to discuss possible solutions that could benefit all countries involved. The course builds on what all the students are learning about their countries to help them decide and produce a viable final project for a vulnerable population. This final assignment is submitted in the last week of the course.

The instructor is actively involved throughout the course. The selected countries are carefully chosen and consist of developing countries that have relatively low per capita incomes and are not heavily industrialized. The interface is colorful and appealing to the eye and video clips of global health around the world give the visual sense that cannot be put into words. Within the learning management system, there are several communication areas such as “talk with the professor” and “ask a question” section and course e-mail. This allows for open communication, community building and trust between instructor and student as well as student to student. In addition, the instructor uses the announcement tool contained in the course to communicate with students and provide them with important information.Video tutorials are also embedded to support learning in applying skills using the social bookmarking tool Diigo. A grading rubric is used to assess learning effectiveness in the following areas: discussions, short essay questions, and final projects. Grading rubrics are readily available to students throughout the course clarifying expectations and grading policies. In addition, written developmental feedback is provided on all graded assignments.

Each semester, the instructor asks students to provide feedback on the course. Students have recommended working together in groups on a selected country and adding more countries to the selected list. Students have commented they have found the course easy to navigate, are more culturally aware and sensitive to the needs of others, and cognizant of the world health perspective.

For future improvements, the following may be added to future sections of the course: blogging, guest lectures, stronger connection of the assignment to real world application, interactive maps, group assignment option, and more European countries.

Supporting Information for this Effective Practice
Evidence of Effectiveness: 

Evidence of Effictiveness is demonstrated through student feedback, end of course surveys, e-mails, and discussion posts. Student and faculty feedback recieved is taken into considersation to help enhance the course. Over the three terms that the course has been offered, enrollment has been steadily increasing. When the course was first offered, there were a total of 4 students. Currently, there are 20 students enrolled in the summer term. 

Quotes from students who participated in the course last semester:

I have been thinking about how much we will be learning about different countries, and I never thought of how we will be able to put these learned issues to use on our everyday lives at work thanks for that”.

“Working as a nurse in NYC I do interact with people from different cultures including Japanese so it is very useful to be aware of specific cultural beliefs”.

I have a new appreciation for global health and organizations like WHO and UNICEF”.

“It amazes me the will of the human spirit to survive, in even such hardship”.

“ As part of a modern world we are not separated from one another, one country from each other, we are all interconnected on many levels”.

Faculty Quote:

“It is a solid course that helps me and students learn how to better contribute to global health”.

How does this practice relate to pillars?: 

Student Satisfaction
Course feedback is actively sought from students as it is used in consideration for course revisions. Feedback is usually provided through course e-mails, discussions, and/or a survey. Through students tone of voice in discussion posts and under the ask the question section, faculty members can get a sense of  student satisfaction. Resources for students include the help desk which offers technological support seven days a week, library resources, and learner support services. Students also use Diigo a web 2.0 tool within the course to add peer based review articles on global health topics to share with their peers. Faculty members design the course by providing detailed instructions, clearly stated course documents, and layout consistency. In return lends itself to less general questions (How do I get to module 1? Where is the syllabus? How am I graded? What is the project about? etc.) from the student and they are able to focus more on the content. Students have commented that they really enjoy participating in this course.


Faculty Satisfaction
Faculty satisfaction is based on many different aspects of the course such as student feedback and communication, layout and design, student progress, and outcome of final project. Faculty who have taught the course have indicated what a exciting experience it is to see students sharing their discoveries, articulating ideas and become passionate for global concerns. Faculty have expressed a significant gain in knowledge related to the topic of global health and nurses’ roles in responding to health disparities. The course provides a means for faculty to become increasingly more culturally competent and to translate that skill in academia and practice.

Equipment necessary to implement Effective Practice: 

Learning Management System, Internet

Estimate the probable costs associated with this practice: 

Cost of Internet, Cost of Learning Management System, Free Web 2.0 tools 

Contact(s) for this Effective Practice
Effective Practice Contact: 
Kimberly Balko, Assistant Professor MS, RN
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Effective Practice Contact 2: 
Jennifer Boisvert, MS
Email contact 2: 
Effective Practice Contact 3: 
Lisa Rapple, MS. Ed.
Email contact 3: