444 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
■ WHY STUDY ABROAD FOR DOCTORAL NURSING STUDENTS?
In an increasingly geopolitical, global- oriented world, it is incumbent that that the most
educated health professionals, including doctoral- prepared clinicians, scientists, and
scholars, have the kinds of real- world experiences that will give them the best context
for discussing the international implications of health issues and in making informed
decisions about health policy and practice. Indeed, the rise of the severe acute respira-
tory syndrome (SARS) virus, the H1N1 flu virus, the deadly Ebola virus, and now the
emergence of the Zika virus (Dreher et al., 2004; Gardner, 2009; Lupton, 2016; Robert
Wood Johnson Foundation, 2014) are vivid recent examples of why nurses, now more
than ever, know that the health of someone on one continent may have a direct impact
on the health of citizens on another.
Increasingly, the international higher education is a big business. Foreign stu-
dents contribute to more than $30 billion to the U.S. economy each year, with
the United States currently by far the largest host country, with more than a quarter of
the world’s foreign students (Institute of International Education, 2015). Even with the
global recession, the global education still grew (Redden, 2009a). However, the Institute
of International Education annually tracks study- abroad numbers (both foreign stu-
dents studying in the United States and the U.S. students going abroad), the previ-
ously reported 1.5% overall rate of participation by the U.S. students is still very low
(NAFSA, 2016 ). The International Association of Universities (IAU, 2014 ) global survey,
conducted in 2013 revealed, “More than twice as many U.S. respondents than all
respondents indicated that internationalization was of low importance to institutional
leaders (11 percent versus 5 percent)” (Green, 2014, p. 2). However, a current survey
of employers found that nearly 40% reported that their organizations have missed out
on international opportunities because they did not have trained personnel (Daniel,
Xie, & Kedia, 2014). A 2006 to 2007 report found that only 5.1% of all the study- abroad
students was among those in the health profession majors. At least since 1996, Zorn
suggested that internationalizing the nursing curriculum was essential to prepare the
nurses for the challenges of the 21st century (Zorn, 1996). One critique is that the cur-
rent nursing curricula fail to properly acknowledge the global environment (Benton,
2012; Duffy, 2001), and that any significant movement to more formally globalize nurs-
ing curricula in the United States has been largely absent. A review of the literature
identified several peer- reviewed articles describing U.S.- based study- abroad programs
(Breitkreuz, 2010; Carpenter & Garcia, 2012; Christoffersen, 2008; Fennell, 2009; Folse,
Jarvis, Swanlund, & Timan, 2015; Gilliland, Attridge, Attridge, Maize, & McNeill, 2016;
Johanson, 2006; Levine, 2009; Parker, Locsin, & Longo, 2006; Saenz & Holcomb, 2009),
but there were no study- abroad programs that focused on graduate nursing students
exclusively, much less doctoral students.
Nevertheless, in 2006, the forward thinking doctoral nursing faculty at Drexel
University were convinced that a short- term formal study- abroad experience would be
an innovative enhancement to its DrNP program. It would ideally prepare the students
to better face the contemporary global problems that highly educated nursing and other
health professionals will increasingly be challenged to solve. Similarly, the Duquesne
School of Nursing faculty thought about the importance of an international education
component in their own Doctor of Nursing Program. This chapter provides practical
information related to the approval and funding process necessary to implement these
types of programs and, given the lack of graduate (or doctoral) nursing study- abroad
programs described in the literature, highlight the perspectives of both faculty and stu-
dents who have participated in both programs.