The aim of this research was to describe an international student exchange programme as a context of learning intercultural competence in nursing. Twelve Finnish nursing students who had participated in an exchange programme in the United Kingdom participated. The data consisted of group interviews, learning documents, background questionnaires and research diary notes, and the method of inductive content analysis was used. Study abroad as a process of learning intercultural competence consisted of three ethno-categories: transition from one culture to another, adjustment to the difference and gaining intercultural sensitivity. The exchange programme as a context of learning intercultural competence was characterized by a problematic orientation phase, a study abroad phase that involved stressful but rewarding adjustment to the intercultural differences and an inadequate re-entry debriefing phase. In order for the international experience of nursing students to have an impact on their understanding of diversity, they need assistance in each phase of the programme. Particularly, the students need intercultural tutoring and mentoring to venture into encounters with local people, including direct client contacts, during their study abroad.

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A dialogic tutor-student relationship is important for learning intercultural sensitivity. Tutoring strategies should be developed to assist students' adjustment to the differences in the host culture and to encourage their reflection on personal, experiential and scientific cultural knowledge during their study abroad.

This paper describes the enhancement of cultural competence through trans-Atlantic rural community experiences of European and Canadian nursing students using critical incident technique (CIT) as the students' reflective writing method. The data generated from 48 students' recordings about 134 critical incidents over a 2-year project were analysed by qualitative content analysis. Five main learning categories were identified as: cross-cultural ethical issues; cultural and social differences; health-care inequalities; population health concerns; and personal and professional awareness. Four emergent cultural perspectives for the health sector that became apparent from the reflections were: health promotion realm; sensitivity to social and cultural aspects of people's lives; channels between the health sector and society; cultural language and stories of local people. CIT was successfully used to foster European and Canadian undergraduate students' cultural reflections resulting in considerations and suggestions for future endeavours to enhance cultural competence in nursing education.

This narrative study describes the substance of nursing students' learning in the area of mental health and their responses to the challenges of working in the psychiatric field. The data consisted of 39 critical incidents written by 20 Finnish second-year nursing students during their 5-week mental health placement. The narrative analysis method was used in the data analysis and the configuration of three consistent learning storylines: self-awareness and self-esteem, the nurse-patient relationship and mental health care methods. The three storylines characterized the essence of the students' learning and their responses to the challenges of the psychiatric field during the placement. The students were actively exposed to complicated care situations and patient encounters in which they had to face their own emotions and test coping skills. It seems that the critical incident technique stimulated students' narrative skills and possibly sensitized them for listening at the stories of their future patients.