Person-centred Practice Research Articles

Celebrating Professor Jan Dewing

In this editorial we would like to celebrate Professor Jan Dewing, who sadly died in August. Her relationship with us both was multidimensional. She was a colleague, mentor, educator, co-researcher, supervisor and co-supervisor, but also a friend. Her presence is deeply missed. Our intention is not to provide a full account of Jan’s work and the influence it has and continues to have on individuals and practice. Instead, we start this celebration with personal accounts of our relationships with Jan and how it has influenced our development professionally. This is followed by a celebration of the ways in which we have experienced her contribution to the field of practice development and to participatory ways of working, person-centredness and person-centred practice.

Reaching out to those we teach about: a qualitative appreciative inquiry of older persons’ experience as mentors in a bachelor of nursing programme during the Covid-19 pandemic

Background: This article describes the development and refinement of a component of a first-year nursing course called ‘Theoretical perspectives in nursing care: complexities in seniors care’. Initially developed in 2020 in response to the pandemic restrictions and guided by the philosophy of person- centredness and person-centred practice, a senior mentorship programme called ‘Engaging with your senior mentor in the community’ has become an important element of the broader theoretical course. Aim: To report on the experiences of older persons living in the community who volunteered to be mentors to first-year bachelor of nursing students, and explain how their experiences informed person-centred quality improvements for future courses. Methods: Appreciative inquiry principles guided the study. Qualitative descriptive design methods – online surveys and focus groups – were employed to evaluate the senior mentorship initiative. Thematic analysis was performed to identify themes that described what the experience of participating in the initiative was like from the perspective of the senior mentors themselves. Findings: Our analysis identified five themes: (a) sharing; (b) contributing; (c) listening; (d) self-reflecting; and (e) communicating expectations. Conclusion: Sharing wisdom informed by lived experience can be a rewarding part of ageing. Senior mentors believed they had contributed in a meaningful way to the student nurses’ learning. Implications for practice: This article reaffirms that older persons are keen to participate in education initiatives Insights from the senior mentors will inform educators in health and social sciences who want to incorporate the voices of older persons in their classroom and practice teaching Older persons should be considered potential partners who can help educators develop a culture of person-centredness to help students prepare to appreciate the older persons in their care

In memory of Professor Jan Dewing

Five members of the Post-doctoral International Community of Practice (a subgroup of the Person-centred Practice Research International Community of Practice, of which Jan was formerly the director) came together to agree a process through which we could co-create a poem in memory of Jan. Each of us had developed a relationship with Jan through our doctoral studies, but also through working with her in our organisations and through this journal. These relationships with Jan were unique to each individual but significant for us all. Individually, we each selected Evoke cards (evokecards.com) that spoke to us about our memories and relationship with Jan. Using the cards, we then recorded a video story, sharing our cards and why we had chosen them. We uploaded the stories to an online database so they could be viewed by us all. While looking at the pictures and listening to the stories, we made notes about what was significant for us within the stories. Subsequently, we met virtually to synthesise the collective themes.

Multidisciplinary team healthcare professionals' perceptions of current and optimal acute rehabilitation, a hip fracture example A UK qualitative interview study informed by the Theoretical Domains Framework.

To understand multidisciplinary team healthcare professionals' perceptions of current and optimal provision of acute rehabilitation, perceived facilitators and barriers to implementation, and their implications for patient recovery, using hip fracture as an example. A qualitative design was adopted using semi-structured telephone interviews with 20 members of the acute multidisciplinary healthcare team (occupational therapists, physiotherapists, physicians, nurses) working on orthopaedic wards at 15 different hospitals across the UK. Interviews were audio-recorded, transcribed verbatim, anonymised, and then thematically analysed drawing on the Theoretical Domains Framework to enhance our understanding of the findings. We identified four themes: conceptualising a model of rehabilitative practice, which reflected the perceived variability of rehabilitation models, along with facilitators and common patient and organisational barriers for optimal rehabilitation; competing professional and organisational goals, which highlighted the reported incompatibility between organisational goals and person-centred care shaping rehabilitation practices, particularly for more vulnerable patients; engaging teams in collaborative practice, which related to the expressed need to work well with all members of the multidisciplinary team to achieve the same person-centred goals and share rehabilitation practices; and engaging patients and their carers, highlighting the importance of their involvement to achieve a holistic and collaborative approach to rehabilitation in the acute setting. Barriers and facilitators within themes were underpinned by the lack or presence of adequate ways of communicating with patients, carers, and multidisciplinary team members; resources (e.g. equipment, staffing, group classes), and support from people in leadership positions such as management and senior staff. Cornerstones of optimal acute rehabilitation are effective communication and collaborative practices between the multidisciplinary team, patients and carers. Supportive management and leadership are central to optimise these processes. Organisational constraints are the most commonly perceived barrier to delivering effective rehabilitation in hospital settings, which exacerbate silo working and limited patient engagement.

Person-centred and task-centred care: Impact on mealtime behaviours in nursing home residents with dementia.

Mealtime is a critical daily activity to ensure nutrition, hydration, function and socialisation. Interactions between staff and residents during mealtimes are complex and dynamic processes including verbal and/or nonverbal communication that can be positive/neutral or challenging. This study examined characteristics of and relationships between person-centred and task-centred care and positive/neutral and challenging mealtime behaviours in persons with dementia. This study was a secondary behavioural analyses of videotaped mealtime observations (n= 110) involving 42 unique staff-resident dyads (29 staff and 25 residents with dementia) in nine nursing homes. The refined Cue Utilization and Engagement in Dementia mealtime video-coding scheme was used to code videos during 2019-2020. Dependent variables representing resident mealtime behaviours included positive verbal behaviours, positive/neutral nonverbal behaviours, functional impairments (nonverbal) and resistive behaviours (verbal and nonverbal). Independent variables were staff person-centred and task-centred approaches (verbal and nonverbal). Relationships between resident mealtime behaviours and staff approaches were examined using bivariate analysis and logistic regression. Staff person-centred verbal approaches were associated with resident positive verbal behaviours (OR=1.38, 95% CI=1.09-1.76), functional impairments (OR=0.81, 95% CI=0.66-1.00) and resistive behaviours (OR=1.65, 95% CI=1.18-2.31). Staff person-centred nonverbal approaches were associated with resident functional impairments (OR=1.33, 95% CI=1.02-1.74). Staff task-centred approaches were not associated with resident positive/neutral or challenging mealtime behaviours. This study characterised staff approaches and resident behaviours during mealtime care and provided preliminary support on associations between staff person-centred approaches and resident positive and challenging behaviours. Person-centred mealtime care practice is recommended by focusing on support of common, challenging behaviours and reinforcement of positive behaviours with adequate consideration of individual needs and preferences.

“She was willing to send me there”: Intrafamilial child sexual abuse, exploitation and trafficking of boys

BackgroundBoys subject to intrafamilial child sexual exploitation and abuse (CSEA) - in particular, cases which begin as incest and later evolve into child trafficking for sexual exploitation - face many barriers in disclosing their exploitation, often leaving victims and survivors feeling isolated from society and dismissed or mishandled by service providers such as law enforcement officers, child protection specialists, medical staff and mental health professionals. ObjectiveThis study explores the unique characteristics of intrafamilial CSEA through the sex trafficking of boys, and the barriers to disclosure and recovery experienced by male victims and survivors. Participants and settingTen adult male survivors of intrafamilial child trafficking for sexual exploitation were interviewed multiple times to gain a deeper understanding of intrafamilial CSEA and how it compares and contrasts with non-familial CSEA. Participants in this study primarily came from North America. MethodologyMultiple semi-structured online interviews were conducted with these 10 adult male survivors because they experienced 1) intrafamilial CSEA and 2) being trafficked by their families to be sexually exploited by non-familial perpetrators. The participants were then asked to compare and contrast intrafamilial and non-familial CSEA. The research team employed a descriptive phenomenological approach and interview transcripts were coded, analyzed, and compared to identify patterns of non-verbal CSEA indicators and thematic narratives. The study also explored the internal and external barriers to disclosure reported by participants. Trauma-informed, person-centered practices were used throughout the entirety of the study to minimize harm to participants. The research team employed a co-productive approach using participants' initial interviews and feedback to formulate new questions for later rounds of interviews and by having the participants confirm the accuracy of their respective quotes and case summaries. Results and discussionThis study highlights several CSEA modalities, such as “boy-swap” events and local/national/transnational trafficking rings engaged in CSEA of boys. It also discusses how survivors' experiences differed between intrafamilial and non-familial CSEA and trafficking, and how familial settings may facilitate concealment of CSEA. Participants described various modus operandi used by abusers, traffickers, and buyers of all genders. While all 10 intrafamilial CSEA cases included male perpetrators, female perpetrators were also present in nine of them. In addition, participants identified various psychological and physiological CSEA and trafficking indicators that evidenced their victimization during their childhood years. All 10 survivors reported long-term health consequences into adulthood and scored highly on Adverse Childhood Experiences (ACEs) questionnaires. Recommendations and conclusionFindings underscore the importance of trauma-informed practices for identifying, liberating, and rehabilitating victims and survivors. Participants reported receiving more effective assistance from service providers that exhibited trauma-informed practices. Traditional gender stereotypes may hinder the ability of service providers to recognize and provide support to boys victimized and trafficked by their families for CSEA. Consequently, service providers may stand to benefit from training on 1) trauma-informed, person-centered practices and 2) conscious and unconscious biases, particularly those related to gender. Survivors in recovery require expanded support services, such as the provision of safe housing, online/in-person support communities, and professional/life skill training. Co-productive research methods that integrate the views and experiences of CSEA and trafficking survivors are also recommended.

Collaborative care planning as a person-centred practice -Interpreted synthesis of four empirical studies and their results

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

Trans voices in social work research: what are the recommendations for anti-oppressive practice that includes trans people?

This rapid review explores research that relates to trans people and social work, with the aim of investigating the experiences of trans people in social work. The article is concerned exclusively with research that platforms the voices of trans people, specifically, those whose input is in direct reference to their experiences in relation to social work. However, the exploration revealed no studies that reference the perspectives of trans social workers. Key recommendations include: the responsible inclusion of trans identities within educational and professional development materials; a visible commitment within social work to confronting transphobia; engaging with practice beyond a binary comprehension of gender; and renewed commitment to person-centred practice that promotes and understands the necessity for self-identification. Additionally, this review restates the need for further ethical research in this area that is more accurately representative and enables the voice and influence of trans people in social work knowledge production.

Dignity in the care of older adults living in nursing homes and long-term care facilities

Depending on the fields and actors involved, dignity may involve, signify, and encompass different meanings. This fundamental right can be subjectively experienced and rooted in a person's perception of being treated and cared for. Care refers to a set of specific activities combined in a complex life-sustaining network, including long-term Care, which involves various services designed to meet a person's health or personal care needs. However, older residents' human rights have been disrespected and widened the gaps between theory and practice regarding the precarious protection of their rights and dignity inside long-term facilities and nursing homes. This paper aims to discuss threats to dignity and elucidate some strategies to promote and conserve dignity in care, including the person-centered practice in long-term care. Some barriers to the dignity of older residents involve the organizational culture, restraints of time, heavy workload, burnout, and lack of partnership between the residents, their families, and the long-term care homes' staff. Person-centered integrated care quality frameworks are core components of a good quality of care in these spaces in high-income countries. Unfortunately, the COVID-19 pandemic highlighted how weak long-term care policies were and demonstrated that much progress in the dignity of care in long-term care facilities and nursing homes is needed. In low- and middle-income countries, long-term care policies do not accompany the accelerated and intense aging process, and there are other threats, like their invisibility to the public sector and the prejudices about this service model. It's urgent to create strategies for designing and implementing sustainable and equitable long- term care systems based on a person-centered service with dignity to everyone who needs it.

Research priority 2: How can occupational therapists ensure that person-centred practice is central to how they work? Start by rethinking the person

Research priority 2: How can occupational therapists ensure that person-centred practice is central to how they work? Start by rethinking the person

Beyond the Point of No Return: A Discourse Analysis of Healthcare Professionals' Perceptions of Digitally Supported Person-Centred, Integrated, and Proactive Care.

Most countries are facing a common challenge: a rise in the number of chronically ill patients and limited medical resources. The combination of digital support and the principles of person-centred, integrated, and proactive care (Digi-PIP care) services constitutes the most ambitious initiative for patients with long-term needs. While there is research on digital support, person-centred, integrated, and proactive care, the combination of these components has been less explored.The data set consisted of 29 qualitative interviews with healthcare professionals involved in four Nordic Digi-PIP care initiatives. Building on prevailing discourses on the modernisation of healthcare, we used discourse analysis to determine how the professionals discussed their perceptions and experiences of the care transformation initiatives.We identified four discourses illustrating that, despite challenges with adoption, the vision of Digi-PIP care was strongly embedded among participants across professions and contexts. In contrast to the discourses on their separate components, the emergent discourses on Digi-PIP care were surprisingly consistent. The new care model was found to be beneficial for patients, healthcare professionals, and society.Digitalisation may vitalise and even catalyse person-centred, integrated, and proactive practices. To the employees involved, Digi-PIP has moved beyond the point of no return; it is the future of modern healthcare.

Personalisation in disability policy and practice: an analysis through the lenses of professional actors

ABSTRACT ‘Personalisation’ is nowadays a very popular concept in disability policy and this article – drawing on my PhD research project in the English and Lombardian context of social care services for disabled people – aims to explore the translation of personalisation from policy into practice; hence the ways in which personalisation policy makes its way into disability services. In particular, drawing on street-level-bureaucracy, policy practice and network theories, personalisation is analysed here through the lenses of professional actors. The application of a mix of qualitative research methods brought me to two main conclusions: 1) narrow approaches to personalisation coexist with broader ones, leading to very different roles for professionals charged with translating personalisation policy into practice; 2) power differences and asymmetries are at play among different professional actors, with some having stronger discretional and policy steering capacity compared to others when it comes to informing person-centred care practice.

Impact of strengths model training and supervision on the therapeutic practice of Australian mental health clinicians.

This study explored the impact of Strengths Model training, supervision and mentorship on the practice of a group of multi-disciplinary mental health clinicians that included mental health nurses, social workers, psychologists, and occupational therapists. A qualitative approach that combined critical realism and grounded theory was used. The findings demonstrated how a substantive category, Getting to Know Clients Better, facilitated participants' progression through a basic social psychological process, Becoming a Strengths-Informed Practitioner. This process consisted of a discernible and sustained change towards more person-centred, hopeful, and recovery-oriented practice. The findings also described an underlying generative mechanism for this, the Client Becomes Visible, which accorded with theoretical models of empathy, based on enhanced cognitive processing. The strength-based approach to practice facilitated the establishment of a collaborative relationship and a stronger therapeutic alliance between the client and clinician. The research demonstrated that Strengths Model is an effective vehicle for improving recovery-orientated mental health services.

Development of a framework for person-centred physiotherapy

Background There is a growing call for healthcare to focus on person-centred practice. This can lead to improved outcomes for patients in terms of physical and psychological health. Challenges exist around how person-centredness is understood in physiotherapy. Having a physiotherapy framework would help support a shared understanding of the meaning of person-centred physiotherapy. Aim The aim of this study was to locate and synthesise studies which have a conceptualisation of person-centred physiotherapy practice. These were used to develop an overarching conceptual framework for person-centred physiotherapy practice. Methods The framework was developed through a systematic process involving a systematic literature search, screening studies against eligibility criteria, data extraction, data synthesis, naming and defining core constructs of person-centred physiotherapy practice, and generation of a pictorial representation of an overarching conceptual framework. Results The person-centred physiotherapy framework is comprised of four constructs: physiotherapist characteristics, which focuses on the knowledge and skills for clinical proficiency, attributes of the physiotherapist, reflection and self-awareness; person-physiotherapist interaction(s), which focuses on partnership, empowerment and self-management; the environment, which focuses on coordinated healthcare delivery, culture of the organisation and practice environment, and the physical environment; and the ongoing unique journey of the person and self-management. The relationships between the constructs reflect the complex nature of person-centred practice. Conclusions The framework presented can be used to better understand person-centred physiotherapy with a view to enhancing practice. The framework needs to be tested further through empirical research to establish its utility.

Goal-Setting in clinical practice: a study of health-care professionals’ perspectives in outpatient multidisciplinary rehabilitation of patients with spinal cord injury

Purpose Spinal cord injury is a complex condition requiring long-term rehabilitation. Goal-setting is considered an essential part of rehabilitation, however, knowledge of how goal-setting is practised across health-care professions, settings and diagnoses are scarce. The purpose of the study was therefore to explore health-care professionals’ perspectives on goal-setting practice in outpatient multidisciplinary rehabilitation targeting patients with spinal cord injury. Materials and methods An anthropological study combining participant-observation and focus group interviews. Data were analysed using reflexive thematic analysis. COREQ checklist was used to report the study quality. Results Health-care professionals experienced a field of tension between internationally recommended goal-setting criteria, requiring goals to be specific, measurable, realistic and time-based, and a practice influenced by patients presenting complex needs. The challenges were managed using a negotiation strategy characterized by a tinkering approach to adjust notions of measurability, realism and time frame into practice. Also, health-care professionals were challenged in relation to practising a person-centred rehabilitation approach. Conclusions We suggest rethinking the goal-setting process by allowing recommended goal-setting criteria to be adapted to a specific practice context while acknowledging goal-setting practice in its variety and flexibility as a strength. Furthermore, improved incorporation of patients’ perspectives in the practice is needed. Implications for rehabilitation To strengthen person-centred rehabilitation practice, clinicians should actively search for and engage patient-identified needs and preferences in shared goal-setting. Standard criteria of goal-setting should comply with the individual and specific participation in the everyday life of patients with SCI. SMART goals are not always the right way to formulate rehabilitation goals. A flexible and pragmatic approach is needed to reach a balance between the patients’ complex needs and the recommendations for goals to be specific, measurable, realistic, and time-based.

How are the mealtime experiences of people in residential aged care facilities informed by policy and best practice guidelines? A scoping review

BackgroundMealtimes are embedded routines of residents living in residential aged care facilities (RACFs) that directly impact their health and quality of life. Little is known about how mealtime experiences are informed and affected by structures such as government and organisational policies and processes. This scoping review used Giddens’ (The constitution of society: outline of the theory of structuration, 1984) Structuration Theory to investigate how governance structures related to mealtime practices inform residents’ mealtime experiences.MethodsUsing Arksey and O’Malley’s (Int J Soc Res Methodol 8:19–32, 2005) scoping review framework, a systematic database, grey literature and policy search was completed in May 2020 and updated in July 2021. From 2725 identified articles, 137 articles were included in data charting and deductive analysis, and 76 additional Australian government policy papers were used interpretatively.ResultsData charting identified that the included studies were prominently situated in Western countries, with a progressive increase in publication rate over the past two decades. Qualitative findings captured structures that guide RACF mealtimes, how these relate to person-centred mealtime practices, and how these facilitate residents to enact choice and control.ConclusionsCurrent policies lack specificity to inform the specific structures and practices of RACF mealtimes. Staff, residents, organisational and governance representatives possess different signification, legitimation and domination structures, and lack a shared understanding of policy, and how this influences processes and practices that comprise mealtimes.

CULTURE IN PERSON- AND PEOPLE-CENTERED HEALTH CARE

Background: Person- and people-centered medicine (PCM) underscores the importance of accounting for culture and cultural values.
 Objective: The objective of this article is to clarify the concept of culture and describe misleading or faulty ways of understanding this concept in averting blind-spots for culture in person- and people-centered health care.
 Method: Drawing on the conceptualization of PCM, the philosophy of values, values-based Practice, and principles of anthropology, misleading or faulty ways of understanding the concept of culture are identified by meeting criteria of conflation, confusing contingency as if necessity, being too narrow, or contracting blind-spots.
 Results: Six ways of understanding the concept of culture are identified that may undermine person-centered practice. These may be corrected by understanding culture as necessarily constituted by a set of shared practices underpinned by values. So understood, this clarifies the distinction between culture and group identity, and that: subcultures and counter-cultures are proper cultures; symbols, language, and geographic locality are contingent qualities of culture; culture is subject to change and not fixed by history or an individual’s group identity; and that culture is readily ascribed to others/foreigners owing to blind-spots for one’s own culture.
 Conclusion: By averting too narrow an understanding of culture and overcoming one’s blind-spot for one’s own cultural values, the clinician may recognize and account for culture and cultural values in person-centered health care. When the differences in cultural values bring about conflict or potential alienation in the interpersonal relationship, the differences need to be subjected practically to a process of dissensual decision-making, accounting for the uncommon ground within a safe space created by common ground and consensus.

Person-Centered Practice in Hospitalized Older Adults with Chronic Illness: Clinical Study Protocol.

The aging trend in the population, the high rate of hospitalization, the affliction by multiple chronic illnesses, and the increased vulnerability of older people when hospitalized undoubtedly require a person-centered approach to healthcare—an approach that values a person’s participation in the healthcare relationship, supports shared decision making and mutual understanding, and respects a person’s values, preferences, and beliefs. However, despite widespread recognition that the adoption of such a clinical practice paradigm is paramount, its implementation and development are still challenging for various health systems and professionals worldwide. The implementation strategy for such a healthcare paradigm must be based on each country’s health system organization and practice contexts, as well as the professionals involved. The present work aims to provide guidelines for the understanding of the state of development of person-centered practice in the daily care of hospitalized older adults with chronic illnesses within the internal medicine department of a secondary hospital in an urban area of Portugal. We focus on the characterization of (i) the perceptions of a multidisciplinary team working at an inpatient hospital department of person-centered practice, (ii) the perceptions of hospitalized older adults with chronic illnesses about person-centered practice, (iii) the work culture of an inpatient hospital department with a high prevalence of older adults with chronic illnesses, (iv) the Person-Centred Practice Framework at the organizational and structural levels of the healthcare system, and (v) the elements that influence the implementation of person-centered practice at the individual, organizational, and structural levels in this specific hospital context. To this end, a mixed-methods analysis with a convergent design was planned to use questionnaire instruments to collect data in parallel and independently from distinct samples of health professionals and older inpatient adults within this department. Furthermore, health policies and strategic plans will be analyzed to identify and evaluate references and guidelines for the practice of person-centered care. Studying the dimensions of clinical practice in this specific healthcare context following the Person-Centred Practice Framework can allow us to understand the extent of its development in terms of prerequisites, care environment, care processes, and the macro-context of the healthcare system. Therefore, it is possible to identify and characterize the dimensions achieved and those that need to be improved and, thus, establish a starting point for the definition of new strategies to advance practice towards person-centeredness and monitor changes in healthcare practice.

The experience of staff utilizing data to evaluate and improve person-centred practice: An action research study.

AimExplore how nurses and midwives use patient experience data collected from a mobile health app to influence the development of person‐centred practice.DesignParticipatory action research, underpinned by the Person‐Centred Nursing Framework and Practice Development principles.MethodsSix clinical units in a large health district engaged in three action cycles from 2018 to 2020 using a mobile health app. Nursing/midwifery staff on the units (N = 177) utilized data collected via the app to evaluate and improve person‐centred practice. A pre–post survey using the PCPI‐S was conducted to evaluate staff perceptions of person‐centredness. Data from the surveys (n = 101 in 2018 and n = 102 in 2020) and 17 semi‐structured interviews were used to understand the influence working with these data had on person‐centred practice. The Guidelines for Best Practices in the Reporting of Participatory Action Research have been used to report this study.ResultsImprovements in person‐centred practice were noted across both data sets. There was a statistically significant increase in two domains of the PCPI‐S in the independent t‐test and across all three domains in the paired t‐test results. Thematic analysis resulted in the identification of six themes: Getting everyone on board, once we understood, keeping on track, there's a person in the bed, knowing you're doing a good job and improving over time.ConclusionEngaging with the data collected from the app in a facilitated and collaborative way results in increases in person‐centredness.ImpactThis study provides insight into how nurses and midwives used data from a mHealth app to evaluate and improve person‐centred practice. Utilizing the data generated by the app resulted in increased person‐centredness amongst staff and changes to practice and culture. Nursing and midwifery teams who are supported to engage with patient experience data in an action‐oriented way will see person‐centred practice improvements, affecting patients and staff.

Transatlantic Collaborations: Baccalaureate Nursing Students' Experiences of Participating in a Semester-Long Study Abroad Program.

AIMThe aim of this study was to describe students’ experiences during a 15-week semester involving clinical placement in an Irish university.BACKGROUNDInternationalization is promoted and facilitated through study abroad initiatives within nurse education. Collaborations were developed between one university in the United States, an Irish university, and service partners. This study abroad initiative involved planning logistics, curriculum learning opportunities, and negotiating clinical placement in meeting state professional requirements.METHODA qualitative descriptive approach was used. Following ethical approval, 19 fourth-year students participated in focus group and individual semistructured interviews. Data analysis followed a thematic approach.RESULTSConnecting our worlds details a process of acclimatizing, navigating learning, and using person-centered practices, illustrating meaningful learning in a journey of personal and professional development.CONCLUSIONMoving beyond the rhetoric of globalization is critical in future proofing initiatives in developing nursing practitioners while balancing potential safety risks in a post-COVID-19 era.