ECU News Services
March 21, 2017
By Natalie SayewichUniversity Communication
Sometimes leaving your comfort zone is the best way to grow.
That’s one reason why students and faculty from the College of Nursing at East
Carolina University have made annual treks to Nicaragua the past seven years.
Now the college’s partnership with a nursing school there
has culminated in a published study about how both schools can grow their
teaching methods to better fit the needs of their students and their
For seven years, in collaboration with students and faculty
from ECU’s Brody School of Medicine and a non-governmental organization –
Project Health for León –
representatives from the College of Nursing have worked to improve clinical
care in Nicaragua while furthering their own education. Because Nicaragua is
one of the poorest countries in the western hemisphere, access to both
educational tools and health care resources is limited there.
East Carolina’s involvement with Project Health for León originated nearly 20 years ago when Brody
School of Medicine faculty members Dr. Jack Rose and Dr. Harry Adams began
taking medical teams to León,
Nicaragua, to offer specialized care and life-saving surgeries to people who
otherwise would not have access to them.
Soon they began taking medical students and later invited
the College of Nursing to collaborate. This resulted in the Nicaragua
Interprofessional Study Abroad Program, a unique model of interprofessional
education that is both a cultural and clinical immersion.
The College of Nursing’s work with the National Autonomous
University of Nicaragua-León Nursing
School over the years shed light on the differences and similarities in
curricula and teaching methods between the two schools. After observing those
differences firsthand, faculty from both schools decided to study them more
closely to find out what they could learn from each other. Their findings – and
the model they created to evaluate and compare their curricula – will be
published in the April 2017 issue of the professional journal Nurse Education Today.
“We said ‘How do we teach nursing in our separate
countries?’ And then ‘Is there a way that we can provide an evaluation of
that?’” said Dr. Donna Lake, a clinical associate professor in the College of
Nursing who authored the study along with several other faculty members from
both nursing schools.
Lake designed a system to compare the two schools’
undergraduate curricula and learned that the school in Nicaragua focused more
on public health and community-based health care, while ECU’s curriculum is
based more heavily on the inpatient setting.
“They taught us to consider integrating more outpatient
rural health teaching in our curriculum and shared community health case
studies to be utilized in our simulation labs,” Lake said of her Latin American
collaborators. “We, in turn, gave them some simulation scenarios, like blood
Dr. Debra Kosko, a co-author of the study and clinical
associate professor in the College of Nursing, agreed that the study shed light
on ways both programs could improve. She said the Nicaraguans appreciated that
they could focus more on inpatient and acute care.
“We both agreed that we would like to see our [curricula]
evolve to have more focus on prevention,” she said.
This year’s two-week trip in February enabled medical
students and doctorate of nursing practice students – who are training to
become family nurse practitioners – to work alongside each other and Nicaraguan
health care providers in inpatient and outpatient settings. They staffed
primary care clinics; provided specialty care for cardiology, HIV and
obstetrical patients; and observed the surgical team, who performed eight heart
surgeries during their stay.
“We were able to share knowledge from our programs and from
our past experience working in the medical field together, so that was an
important aspect of the trip,” said doctorate of nursing practice student Grace
Anglin, who made her second trip this year.
Another student benefit of the Nicaragua experience: they’re
often presented with cases they are unlikely to encounter in the United States.
“They have the opportunity to hear certain heart murmurs and
examine other kinds of abnormalities that, in this country, would have been
repaired at birth,” Kosko said. “It’s a very rich physical exam experience.
You’re really learning to go by what you’re hearing and feeling and seeing as
opposed to reading laboratory results and EKGs because they don’t have that
kind of capability.”
Without many of the diagnostic tools available in the U.S.,
such as CT scans and MRIs, students learn the importance of getting detailed
patient histories and how to rely on their physical examination skills.
A lack of resources and access to certain medications in
Nicaragua also demands that nursing and medical students consider alternative
treatment options to what they might recommend in the States.
“There was an infant and the mother was struggling because
the baby needed this medicine and they didn’t have it in a liquid form,” Kosko
said. “So she was trying to crush it and give it to the baby, and the baby was
spitting up… we were trying to figure out what else we could tell the mother to
do since the medication was not available as a liquid.”
Anglin said that immersing herself in the culture and
dealing with patients also helped improve her Spanish, a skill that is highly
advantageous for nurses practicing in the United States.
“I’ve taken four years of Spanish in my education, but being
there learning from people who actually use that language makes you realize how
deficient you are with that,” she said. “Other than English, the most common
language we encounter for patients is Spanish, so it’s definitely important to
have at least a basic understanding of Spanish.”
here to read the article authored by Lake, Kosko, Dr. Martha Engelke, Dr.
Donna Roberson and their Nicaraguan colleagues in Nurse Education Today.