Resiliency, Stress, and Culture Shock: Findings from a Global Health Service Partnership Educator Cohort

Abstract

Background: Global health field assignments for medical and nursing professionals include a wide variety of opportunities. Many placements often involve individuals practicing in settings very different from their home environments, relying on their professional experience to help bridge cultural and clinical divides.Objectives: There is limited information about the individual factors that might lead to successful longer-term global health experiences in non-disaster settings. In this paper, we report on one cohort of health professionals' experiences of culture shock, stress, and resiliency as volunteers within the Global Health Service Partnership (GHSP), a public-private collaboration between Seed Global Health, the US Peace Corps, and the US Presidents Plan for Emergency Aids Relief (PEPFAR) that placed American medical and nursing educators in five African countries facing a shortage of health professionals.Methods: Using the tools of Project PRIME (Psychosocial Response to International Medical Electives) as a basis, we created the GHSP Educator Support Survey to measure resiliency, stress, and culture shock levels in a cohort of GHSP volunteers during their year of service.Findings: In our sample, participants were likely to experience lower levels of resiliency during initial quarters of global health placements compared to later timepoints. However, they were likely to experience similar stress and culture shock levels across quarters. Levels of preparedness and resources available, and medical needs in the community where the volunteer was placed played a role in the levels of resiliency, stress, and culture shock reported throughout the year. Conclusion:The GHSP Educator Support Survey represented a novel attempt to evaluate the longitudinal mental well-being of medical and nursing volunteers engaged in intense, longterm global health placements in high acuity, low resource clinical and teaching settings. Our findings highlight the need for additional research in this critical area of global health.

Experiences of health professional students’ participation in the GEMx regional elective exchange program in Africa

“…From the literature, under the value of global perspectives, specifically cultural awareness, and integration, students who participated in the North-to-South electives have often reported difficulties (Kumwenda et al, 2014). This is often referred to as cultural shock, which is an occurrence where one finds difficulty in integration when in a setting they are not familiar with Mitha et al (2021). In the South-to-South electives, given exposure to almost similar settings, integration and the value of global perspective in relation to cultural awareness and integration just like in this study are often easily navigated which could be a strength.…”

Culture Shock in Nursing: A Concept Analysis

“…The difficulties arising from culture shock may compound the existing challenges faced by individuals in their current work environment. Apart from the stress from cultural unfamiliarity, healthcare providers undergo work-related stress that can profoundly affect their overall well-being, and this stress may result in adverse clinical outcomes, including medical errors, compassion fatigue, and unprofessional behavior [5]. In an intercultural setting, differing interpretations of behavioral norms, variations in understanding nursing care, and ineffective communication hinder collaboration within a diverse nursing workforce while migrant and minority nurses encounter biases, and verbal and sexual harassment originating from their clients [6].…”