This article stems from a larger ethnographic study that primarily explored nurses' cancer pain management in Sri Lanka. The findings presented in this article report on two aspects revealed in that study: the Sri Lankan health-care system and nursing. The findings indicate that the Sri Lankan health-care system is under considerable strain. Poor hospital management allows doctors to admit too many patients, resulting in chaotic and overcrowded work environments with unsustainable resources. This then impacts on the role of the nurse. This study highlights the adverse conditions under which nurses in Sri Lanka try to administer care, within a powerless and unchanging professional situation. Although this study extends the level of understanding of the situation for nurses in a government hospital, it also offers directions for policy-makers and international nursing organizations to improve nursing education and governance in Sri Lanka.

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A pilot study was undertaken to ascertain the changes in conceptual understanding that resulted from participation in a study abroad programme in Chiang Mai in Thailand of a small group of Australian final year nursing students. Students' conceptual understandings were measured by means of open-ended interviews based on a case study scenario describing health conditions in a hypothetical Thai village. Students were asked to imagine that they had been appointed to work as a community health nurse in the village and describe how they would undertake the task. Shifts in understanding were detected by interviewing the participants before, during and after their participation in the programme and comparing their responses. The results of this limited study indicated that the impact of participation in the programme was less than expected. Furthermore, the factors of which students tended to show greatest awareness were those about which they had been briefed prior to departure. Nevertheless participants reported they had learnt much from their experiences. It is suggested that the discrepancy between the evidence provided by interview data and students' self-reports may be explained by participation having resulted primarily in the acquisition of the tacit rather than conceptual knowledge.

The changes in attitudes towards cultural difference of seventeen participants in a three-week community health study abroad program to Nepal were compared with the changes in attitudes of a similar group who did not participate in the tour. Participants in the tour group were surveyed eight weeks prior to departure and in the last week of the tour using a twenty-six item questionnaire employing a six-point forced-choice response scale. The responses of participants in the tour group showed significant shifts in relation to eight items compared while the responses for the control group showed no significant shifts. Observed student advantages of participation in this study tour included the development of independent behaviour and positive cultural adjustment and adaptation.

This paper reports on an evaluation of a Teaching and Learning Enhancement Scheme (TALES) program designed to meet the unique need of the 2005 cohort of international nursing students undertaking an accelerated Bachelor of Nursing (BN) program at the Victorian campus of Australian Catholic University (ACU) National. The program involved a team approach with three academic mentors and the international students working together to produce satisfactory learning outcomes through fortnightly meetings and provision of additional assistance including compiling a portfolio, reflective writing, English, including colloquial English and pronunciation, as well as familiarisation with handover and abbreviations common in the clinical field, general communication, assistance with preparing a resume and participation in simulated interviews. This relatively small group of international students (20) confirmed the findings of other studies from other countries of international nursing students' in terms of concerns in regard to studying in a foreign country, namely English proficiency, communication difficulties, cultural differences and unfamiliarity with the health care environment. The assistance provided by the program was identified by the completing students as invaluable in helping them settle into study and successfully complete the theoretical and clinical components of the course.