Recent Graduates’ Perceptions of the Impact of a 1-Month International Service Learning Experience in Kenya During Their Physical Therapist Assistant Education

Abstract

INTRODUCTIONThe use of international service learning (ISL) by health professions educators, including those in physical therapy, can facilitate the development of attributes to serve a global society through the provision of health care services to communities around the world.1-9 The American Physical Therapy Association strongly promotes the engagement of the profession in improving the health and quality of life of people in a global society.10 Attributes including advocacy, health promotion, social responsibility, communication, cultural competence, and citizenship are all professional practice expectations cited in the standards and required elements documents from the Commission on Accreditation in Physical Therapy Education. Both physical therapist and physical therapist assistant (PTA) graduates are required to show competence in serving others with respect regardless of cultural difierences.11-12 The Commission on Accreditation in Physical Therapy Education specifically expects PTA graduates to identify, respect, and act with consideration for patients'/clients' difierences, values, preferences, and expressed needs in all workrelated activities 11(f27) and to participate in professional and community organizations that provide opportunities for volunteerism, advocacy, andleadership.11(P37) Although approximately 43% of entry-level PT education programs in the United States and Canada have some form of ISL or other international volunteer service as part of the curriculum, there is no evidence that this same type of experience exists within PTA education programs.13In general, service learning has been defined as learning experiences that combine community service with specific learning objectives that emphasize preparation before the experience, reflection by the participant, and reciprocity of benefit for the person being served and the person who is serving.14 Pechak and Thompson specifically defined ISL as a structured learning experience where students accompanied by faculty travel to different countries and immerse themselves in a culture different than their own.15(f71)REVIEW OF LITERATUREMany health-related education programs, including occupational therapy, social work, dental hygiene, nursing, physician assistant, and medicine programs, have included ISL and have examined how the experiences influenced the development of the skills, attitudes, and awareness needed by graduates to deliver culturally competent care. The benefits of ISL in these programs were associated with improvements in cultural awareness and understanding, cross-cultural communication skills, the ability to work with people from different cultures, open-mindedness, and an appreciation for community and civic engagement.2-7,8-16-19 Other benefits included the development of cultural appreciation and sensitivity, improved clinical reasoning and leadership skills, increased confidence, and the ability to advocate for the profession and patients.16-18,20,21 Long-term benefits for nurses included a new appreciation for life, a broader view of the profession, and improved confidence and effectiveness as practitioners when working with diverse populations.22Researchers who studied the impact of ISL on physical therapist students found similar professional, emotional, and cultural changes. Both short- and long-term benefits were reported. From a professional perspective, researchers identified short-term improvements in adaptability, critical thinking, collaboration with peers, development of professional identity and role formation, leadership, communication skills, and confidence as a clinician.8,23-26 Short-term emotional changes in physical therapist students were found by Hayward and Charrette,23 who reported statistically significant positive changes in the emotional resilience category of the Cross Cultural Adaptability Inventory.27 Multiple researchers reported improvements in components of cultural competence, such as cultural readiness, ease of acknowledging and accepting diverse populations, expanded worldviews, appreciation for global issues, heightened sensitivity to others' cultural values and differences, and motivation to make culture a primary concern in future practice. …