Imagine this: Students travel to Africa and obtain clinical experiences, increase their cultural competence, and participate in interprofessional practice (not to mention, see one of the seven natural wonders of the world!). These are the highlights of Purdue University's Speech, Language, and Hearing Sciences (SLHS) in Zambia program. Since developing this service-learning program, and after three years of leading it, we share some important lessons that could hopefully benefit similar endeavors.
WHERE DO YOU BEGIN?
Community partners in the destination country are key players in this process. To kick off a service-learning program, initiate discussions with community partner organizations to identify their needs and determine how and whether those needs can be met as part of the program. Ensure that the service projects identified match the learning objectives for the students. Keep in mind that professionals in the destination country are more knowledgeable about their local environment and needs, so listen carefully to their input. In our Zambia program, we focus on identifying community partner needs and evolving the program to meet those needs each year. We have worked with administrators and service providers from 11 community partner organizations over the last three years.
HOW DO YOU PLAN THE COURSE?
Learning all you can about the destination country and their culture is important. We begin weekly classes three months prior to departure; however, planning the course is a year-round process. Our weekly classes consist of presentations on various aspects of Zambia such as the history, economics, health care, culture, and language. We include hands-on activities where students learn to perform clinical activities such as otoscopy and hearing screenings. Students also help prepare and participate in professional development for collaborative partners (e.g., topics such as augmentative and alternative communication [AAC] and typical speech and language development in infants and young children). We adapt coursework each year to match the objectives identified by the community partners.
HOW DO YOU PREPARE TO DEAL WITH CULTURAL DIFFERENCES?
In addition to learning about the culture of the destination country, it is important to reflect on your own cultural biases and be aware of them. We incorporate cultural awareness and development activities in class prior to departure to help students become better prepared. Our students are also assigned e-mail “buddies” majoring in Special Education from the University of Zambia (UNZA), which helps facilitate learning about the culture and life in Zambia. This cultural e-mail exchange culminates with a visit to UNZA when the students get to meet each other in person.
HOW DOES THE PROGRAM ENSURE A POSITIVE IMPACT ON THE COMMUNITY?
One of the challenges of a short-term program is determining its impact on the community. We communicate with our community partners year-round to identify and plan program activities that meet their needs. We follow their lead in planning activities and demonstrate (with materials and equipment that they have local access to) that we will be able to continue the work until our program returns the following year. Although preparation is intensive, the feedback from service providers at our community partner organizations has been positive, such as: “The narrative stories were an awesome idea and they are working great. The kids are responding well and are following the concept intended. We were even considering to make more on some behaviors that we'd like to modify. The toilet cards are great and we have been having this exercise where we jumble the cards and the child arranges them in the order intended. They love it and they are learning well.” Also, “The AAC cards are being used very well and the response is awesome. We recently made one for bullying as it was a vice that was rooting.”
CAN STUDENTS ENHANCE THEIR CULTURAL COMPETENCE THROUGH A SHORT TWO-WEEK STUDY ABROAD TRIP?
Although most students say their lives have been transformed after studying abroad, the notion that students can develop cultural competence simply by going on a study abroad program has been challenged (Berg, et al. Stylus Publishing, 2012). Rather, programs should include intentional activities to enhance cultural competence. Reflecting on cultural experiences is also a critical component and achieved in our program. Although literature about study abroad programs has exploded, there are few publications regarding learning outcomes of students particularly in the speech, language, and hearing professions. Our program is striving to change this by measuring cultural competence using pre- and post-trip questionnaires as well as qualitative data from daily journal entries and final reflection papers. Collected data show that our students consistently increase their cultural competence at the conclusion of the program (Figs. 3 and 4). Sample student comments include:
“I fell into the trap of believing stereotypes, that the Africa we would see would be filled with tragedy. I was naïve to think, even subconsciously, that everyone in Africa struggled with the same things.”
“Traveling to Zambia opened my eyes to the truth. I will never again let myself believe that any culture or group of people all have the same story”.
“It is imperative that we go and explore and see for ourselves, rather than let the media paint us a picture of the world.”
ALL WORK AND NO PLAY?
No study abroad program is complete without some leisure activities to further experience the local culture. Our program includes trips to see the mighty Victoria Falls and the National Museum, and enjoy a game safari, among others.
With the American Speech-Language-Hearing Association listing 77 schools providing study abroad opportunities in the areas of audiology and speech-language pathology, it is important to understand the impact of these programs on the communities and students. SLHS in Zambia is grounded in the premise that services should be culturally relevant, sustainable, and beneficial to the community. It is also important to have a method of measuring change in students to have data supporting the program's impact on students. Study abroad programs with focused course objectives, intentional cultural learning activities, and lots of preparation can provide an exceptional opportunity to prepare future clinicians to think critically, be culturally sensitive, and become tomorrow's global leaders.