Process

A similar process undergirds the three categories of educational consultation. At its core, consultation is a process by which people or systems problem solve. This process involves two-way problem solving and is a dynamic method of seeking, giving, and receiving help. Sometimes those receiving the consultation have most of the answers and just need help reaching the goal or solution. The process has three phases: initiation, progression, and culmination.

Initiation

In starting an international education consultation, there are several questions that need to be answered clearly for all parties involved:

• What are the purpose and outcomes of the consultation?

• What questions/topics need to be addressed?

• What resources are available?

• What resources need to be developed?

Clear answers to these questions provide the basis for the interactions and focus of the consultation.

The first point upon which to seek agreement is in regard to the purpose and desired outcome(s). All parties should be specific as to the joint purpose: developing curriculum or programs, addressing specific organizational issues, and/or building infrastructure. That specific purpose will then define the objectives, and they should be concrete and defined and should reflect the consulter's culture, values, state of science, and resources. Each of the parties may have additional purposes that may be served by the consultation, but the primary purpose to be served and goals to be met should be those agreed on by the consultant and consulter (Memmott et al., 2010). For example, building the consultation within the framework of a service learning program emphases the centrality of the agreed-on purpose of the partnership while acknowledging the benefits of the partnership for all involved (McKinnon & Fealy, 2011).

In defining that purpose, the expected role of the consultant should also be clearly expressed. That definition should include expectations of performance (e.g., conducting classes, designing curricula, delivering continuing education) and time (in preparation, while on site, and upon departure) along with workspace (formal academic or in the field) and payment. Forms and amount of communication expected throughout the consultation should also be clarified. Finally, the shared nature of any intellectual property produced as a result of the consultation should be negotiated up front (George & Meadows-Oliver, 2013).

Building on that shared and defined purpose, the next point of agreement is that of the specific questions and topics to be addressed. Does the consulter desire specific subject matter expertise? Who is the intended audience/target learner? Are there programs for professional growth and development to be built or adapted locally or regionally? Are there national, regional, or local implications for practice, licensure, and credentialing that need to be considered and addressed? Awareness of cultural mores and expectations alongside the current practice ecology of the host country is critical for designing and refining content (Scanlan & Abdul Hernandez, 2014).

Finally, both consultant and consulter need to discuss the resources available. Will translation of materials be needed? What (and in some cases if any) is the access to Internet and library resources? What are the resources necessary for sustaining achievement or reproduction of the final goal? Pioneering work in Somalia and China demonstrates that building capacity with no or minimal indigenous resources can begin by identifying community or governmentally directed needs (Doyle & Morris, 2014; Sherwood & Liu, 2005).

Resources for the consultant (office and living space, fees, and communication assistance overseas and within country through translators if necessary) should all be discussed before the onset of the consultation.

Progression

Once the consultation has begun and the traveler is in country, supports discussed in planning should be identified. Those supports may include translators, teaching and research assistants, evaluators, and collaborators.

Having a cultural touchstone or mentor within the host country who can translate expectations and social constructs will prove to be invaluable (Kim, Woith, Otten, & McElmurry 2006).

Progression throughout the consultation is marked by timeline, benchmarks, and deliverables. All of these should be clearly delineated in the planning stages but may need to be shifted once the consultation is under way. Keeping in mind the scope, purpose, and deliverables of the consultation will keep the project on track. Doing so while attuned to the cultural climate will make the project successful. Clearly identifying the end of the consultation before beginning will help to bound expectations.

Culmination

As the consultation draws to a close, all involved should evaluate the effectiveness of the project. Scheduling for formative and summative evaluations should be set up before beginning the consultation. Several points to consider during evaluation are:

• Were there any secondary responsibilities for program planning, development, or delivery that needed to be met that were not discussed initially?

• Are any return trips needed?

• What follow-on work is needed to foster the consulter's success?

• Does the team that was assembled have plans for other work?

• Are there plans to gauge how the project is doing 3, 6, and 12 months out?

• Did the consultation meet its benchmarks?

• Did the consultation meet the consulter's expectations?

• What were the strengths and weaknesses of the project?

• Can any lessons learned be generalized?

Additional Considerations

Several points should be considered when preparing for international education consultation. The first is to be on guard against cultural tone deafness. The WHO has passed a resolution to set global standards for professional preparation of nurses (Nursing & Midwifery Human Resources for Health, 2009). However, all nurses practice in a local setting. Each setting has different boundaries on and expectations of nursing care. In addition, each setting has specific resources. Those resources determine not only care provision but also the sustainability of education and training for the care providers. Sustainability of projects that come out of the consultation process should be a key consideration in design (Mullan & Kerry, 2014).

Along the lines of sustainability, a point to consider within the consultation planning or delivery is what method or program has the sustainable potential for a ripple effect, that is, a far-reaching capacity for change and professional development (Memmott et al., 2010).

Finally, both the consultant and consulter should enter into their relationship with a clear understanding of the ground rules governing their partnership and an appreciation of potential power sharing that may need to occur within the team (Hunter et al., 2013). As international cooperation and collaboration are critical items necessary to expand both the supply of nurses and nursing faculty, educational consultation has the potential to expand and flourish for the advancement of all involved (Haq et al., 2008).

CONCLUSION

The world is opening up to APRNs who want to practice, teach, or conduct research in international settings. Pressing global health care needs and proven APRN track records in health care delivery, education, and research demonstrate this is a time for APRNs to collaborate with colleagues and other medical professionals to improve health for individuals and communities everywhere. Certainly the challenges and obstacles are great, but few professions are as flexible, dynamic, and urgently needed as that of the APRN.

 
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