Healthcare across the Globe: Inaugural Year for the UD Global Clinical Internship
University of Delaware College of Health Sciences students aren’t only serving their local community. With the introduction of a new Global Clinical Internship Program, our future nurses, physical therapists, medical students and other health professionals are serving the global community. From massive cities to remote villages, our Blue Hens worked hand-in-hand with local medical professionals throughout five continents. So grab your passport and take a ride around the globe while sampling their incredible experiences.
Tortola, British Virgin Islands
With UD nursing instructor Diane Rudolphi at the helm, nursing students flew south to Tortola, the largest and most populated of the British Virgin Islands. In addition to her professional expertise, Diane also grew up in the neighboring U.S. Virgin Islands, offering students an inside perspective into Caribbean culture and medicine. With nurses from schools across the Caribbean, students witnessed a variety of approaches to medical care even within the same hospital.
“On the clinical side, coming from the evidenced-based approach to nursing in the United States, the students were exposed to a much-different approach to medicine,” said Rudolphi.
In addition to working hand-in-hand with B.V.I. nurses, students experienced a close-knit Caribbean community. Even on early morning walks into the hospital, the nursing students quickly learned the social importance of greeting every single person.
Outside the hospital, students saw as many of islands as possible, having more than 60 to choose from in the British Virgin Islands alone. These Hens learned about herbal health remedies, visited the Botanical Gardens and took in the local, delicious cuisine.
The nurses lived and breathed the island country’s history, traditions, and culture-specific healthcare needs, providing a very different experience than a typical college student’s trip to the Caribbean.
In the heart of the bustling capital city of Hungary, Semmelweis University and Budapest Military Hospital hosted UD students and faculty members. For these American students, an immersion into European hospitals and health education afforded each individual the chance to compare two very different healthcare systems. Junior nursing student Jaclyn Natalone noted, “Preventative care isn’t an area of focus like it is in the United States. Hungarians wait to go to doctor until they have obvious symptoms.”
For many students, the Global Clinical Internship was their first time shadowing in an operating room or intensive care unit.
“Not only were we accompanying doctors to see patients, but we were a part of the explanation and course of treatment process,” added Sabrina Casares, a senior nursing student.
Outside of clinical settings, the Blue Hens explored the distinct, rich history and culture of Hungary. Visits to Lake Balaton and Szechencyi Baths gave students a taste of country’s beauty. And trips to the Terror Háza Múzeum (House of Terror) and Hungarian Parliament building provided students a glimpse of the country’s past and present political scene.
From the first bowl of goulash to the last, the Global Clinical Internship in Budapest was a unique taste of medicine.
A project led by School of Nursing Associate Professor Carolee Polek took nursing students to rural Faridabad, India. The students served in a variety of units throughout the hospital, including the Intensive Care Unit, Emergency Room, Cardiac Catheterization Lab and Operating Room. The hospital’s physicians and nurses embraced the students, inviting them to assist with patient care, scrub in on surgeries, and ask questions about procedures. But the transfer of knowledge went both ways.
“They wanted us to explain how every procedure and practice compared to those we use in the United States,” said junior Emily Market. “For example, the safety and infection control precautions used there are very different.”
The students were struck by public health concerns and spent much of the time learning about community resources and environmental issues, such as water and air quality. The students were intrigued by cultural differences discovered during their conversations with clinicians and patients.
“Emergency Room physicians are explaining costs of treatment before patients and families make healthcare decisions,” said Polek. “That’s a scene rarely observed in American healthcare settings.”
Outside of the hospital, students had the opportunity to travel through the Golden Triangle, visit the Taj Mahal, witness a Hindu blessing ceremony in Varanasi on the Ganges River, and ride elephants and camels.
Polek encapsulated the internship by saying, “This trip was truly perfect.”
More than 1,500 miles from Sydney, the patients of Cairns and Hinterland Hospital include Aboriginal and Torres Strait Islander Australians, making the Queensland community an ideal setting for learning the importance of cultural competency in healthcare. With some patients walking around the hospital with no shoes, students quickly realized they were in a very different medical environment than they had experienced in Delaware.
“Many patients travel hundreds of miles from deep in the Australian bush to seek medical care,” said Amy Johnson, School of Nursing Professor. “The students jumped right in with the Australian nurses; they truly blossomed.”
One such student was Nayana Gadde, a nursing student, who gained an enormous appreciation for the Aboriginal people.
“The internship opened my eyes to the challenges faced by native populations like the Aborigines,” said Gadde. “We all learned to communicate differently with them; it’s essential to recognize and understand a patient’s cultural background to build rapport, make the patient comfortable and provide a plan of care.”
The pre-med, nursing and exercise science students learned how to dress wounds, take vital signs and document results. Many students became interested in nursing units that they gave no consideration to before the internship.
The local staff was eager to teach the Delaware students not only about Australian healthcare, but also the culture. The Blue Hens experienced Australia’s ‘Royal Flying Doctor Service,’ which combats the country’s challenging terrain by flying medical professionals to remote locations and bringing patients in remote regions to hospitals. Of course, the students interacted with more than a few koalas, kangaroos and wallabies. They also practiced throwing spears and boomerangs with the Tjapukai Aboriginal tribe, who make this activity look much easier than it is.
Gadde concluded, “All of us came out of that trip more educated about the healthcare in a global context and will use the skills learned in our future nursing professions.”
Sacred Valley of Peru
School of Nursing Instructor Lisa McBeth led a group of rising University of Delaware junior and senior nursing students high into the Peruvian Mountains. As the students traveled through the Sacred Valley of Peru to towns not even traceable on Google Maps, they learned that healthcare was rarely a priority. Hygiene at higher altitudes was minimal, dental care was often ignored and vision left unaddressed.
“We visited villages that are essentially untouched by modern civilization and needed healthcare education at its most basic,” explained McBeth. “They didn’t even know how someone got pregnant.”
A major contribution of students was sexual health education. The locals were uninformed, but eager to learn. The Hens educated villagers of all ages, from the elder male leaders to young women.
“Much of the population was unfamiliar with reproductive anatomy, menstrual cycles and family planning,” explained senior Stephanie Yost. “There was an audible ‘whoa’ after we explained the process of fertilization.”
In addition to educational efforts, the students rode sand dune buggies at sunset in Huacachina, visited the legendary city of Machu Picchu, and took in the incredible Peruvian landscapes — jungles, deserts, cities, mountains and beaches.
“Peru taught me many things, but one of the largest takeaways from my experience was that there is always reciprocal sharing when cultures collide,” adds Yost. “Volunteering and education is never a one way street and I received endless lessons from some of the most joyful, peaceful and strong people I have ever met.”
Ba Vi, Vietnam
Blue Hens preparing for careers in medicine, physical therapy, and occupational therapy learned the true meaning of rural healthcare during their summer in Vietnam. While two students stayed in the metropolis of Hanoi, seven more ventured into the heart of the county to Ba Vi. In this rural setting, even when a problem is identified, medical professionals are often thwarted by a lack of infrastructure and medical supplies.
“Vietnamese culture demands you to take control of your own situation and it certainly applies to hospital settings,” said Matt Drexler, Study Abroad Coordinator for the Institute for Global Studies, who accompanied the group.
The students learned important health and cultural lessons at the Thuy An Rehabilitation Center for Disabled Children, where an old bombshell doubles as a dinner bell and a powerful reminder of the war. The interns worked with residual Agent Orange victims who seek treatment at the center to combat the health issues left behind by the defoliant. The student interns worked with Thuy An’s staff of doctors, therapists, and volunteer coordinators, overcoming language barriers and making do with limited resources.
“Gaining an international perspective of healthcare will greatly enrich my career,” remarked Jillian Meyers. “I have interned and volunteered in occupational therapy before, but a global point of view can only make me a better therapist.”
Pueblo of Zuni & Navajo Nation
The term ‘global internship’ seems misleading when traveling to New Mexico, but six dietetics and nutrition students who visited the pueblo of Zuni and the Navajo Nation quickly found a culture as unique as a distant land. Learning from health professionals that specialize in caring for the Southwest Native American population, these Blue Hens studied health problems and intervention strategies. As students watched pharmacists, dieticians, nurses and physicians all working together to solve patient problems, they saw their classroom lessons in action.
“I never fully understood how critical it is to work as a healthcare team outside of the classroom until my experience this summer,” said senior Lisa Conticello.
A major health issue facing Southwest Native Americans is Type 2 diabetes, a disease that all health facilities are making a top priority. The students were hands-on in diabetes prevention classes, health coaching sessions and home visits.
In contrast to so many other cultures, the Southwest Native Americans are less concerned with the concept to time and more focused on the importance of personal interactions. Students saw the value of building rapport and relationships with their patients.
“Only a complete immersion into these cultures allowed me you understand their complexity,” added junior Kelsey Felter. “Working with the Zuni and Navajo was a life-changing opportunity.”
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