Meeting Global Rehabilitation Needs: The Development and Evaluation of an International Visiting Rehabilitation Student Program.

Collaboration to increase capacity for healthcare professionals requires careful planning, open communication, implementation, formative and summative evaluation, and sustainability. International collaboration to meet the rehabilitation needs of China requires a supportive structure of faculty and staff implementing the program. The purpose of this article is to explore the development of a collaborative international rehabilitation education program and illustrate outcomes as they relate to professional development, cultural competency, and healthcare team skills. A retrospective analysis of program assessment data was completed including pre and posttest survey results and focused interviews. Results indicate that program participants had a significant positive change in values and beliefs towards cultural diversity and increased awareness of interdisciplinary team skills which contributed to overall professional development as future rehabilitation practitioners. The description and assessment of the program also serves as a framework for the development of future collaborative international rehabilitation education programs. Future research could explore institutional growth and faculty development of collaborating educational institutions.

Internationally educated occupational therapists transitioning to practice in Canada: A qualitative study.

BACKGROUND/AIM: While internationally educated occupational therapists (IEOTs) may assist Western countries in addressing workforce shortages, their transition to practice can be difficult. Provincial and national levels of government in Canada have funded initiatives to address the barriers experienced by IEOTs. The purpose of this study is to identify the key forces shaping the experiences of IEOTs transitioning to practice in Canada. METHODS: An interpretive description approach was taken to interview 11 IEOTs who graduated from the Occupational Therapy Examination and Practice Preparation (OTepp) program. Data analysis was guided by the theoretical scaffolding of the occupational therapy profession. Two team members, who are also occupational therapists, developed codes and categories independently and then through discussion reached a higher level of interpretation. RESULTS: The experiences of IEOTs in Canada were shaped by two key forces: Realising that more than exam preparation is required and the impact of previous person, environment and occupation transactions. Participants underestimated their learning needs related to their transition to Canadian practice. As they engaged in the OTepp program, they realised that their learning extended beyond that required for the national certification exam. Also, the extent to which the participant (person), previous context (environment) and previous practice (occupation) were similar to Canadian therapists, influenced IEOTs' performance in OTepp and their overall transition to practice. The Person-Environment-Occupation (PEO) model provided a framework to contextualise this theme. CONCLUSION: IEOTs will benefit from individualised learning needs assessments and education plans to address their specific needs. At an international level, the occupational therapy profession must engage in dialogue about the differences between education programs and the resulting implications for the profession. More research is also needed to understand the experiences of IEOTs who withdraw from or do not engage in formal supports.

Best Practices in Bridging Education: Multiple Case Study Evaluation of Postsecondary Bridging Programs for Internationally Educated Health Professionals.

AIMS: Bridging education for internationally trained professionals has grown in popularity, but little is known about promising practices for bridging education in allied health professions. This paper addresses this gap by examining the expected outcomes of effective bridging programs, the key features that contribute to their effectiveness, challenges faced by bridging programs, and the appropriate role of regulatory colleges, government, employers, and professional associations in bridging education. METHODS: We conducted a mixed-methods multiple case study analysis of seven bridging programs in Ontario, Canada, in five allied health professions: medical laboratory technology, medical radiation technology, diagnostic medical sonography, respiratory therapy, and physical therapy. RESULTS: Effective bridging programs are accessible and flexible in content and format. The key challenges include developing curricula tailored to participants' needs, identifying appropriate format for program delivery, obtaining clinical placements for participants, and achieving financial sustainability. Government, professional, and educational stakeholders should play a central role in bridging education planning and delivery. CONCLUSION: The success of a bridging program relies on two key components-program design and infrastructure. Partnerships with government, professional, and educational stakeholders facilitate the development of good bridging programs.

Development and validation of a written credentialing examination for overseas-educated dietitians.

AIM: Health professionals seeking employment in foreign countries are commonly required to undertake competency assessment in order to practice. The present study aims to outline the development and validation of a written examination for Dietetic Skills Recognition (DSR), to assess the knowledge, skills, capabilities and professional judgement of overseas-educated dietitians against the competency standards applied to dietetic graduates in Australia. METHODS: The present study reviews the design, rationale, validation and outcomes of a multiple choice question (MCQ) written examination for overseas-educated dietitians based on 5 years of administration. The validity of the exam is evaluated using Messick's validity framework, which focuses on five potential sources of validity evidence-content, internal structure, relationships with other variables, response process and consequences. The reference point for the exam pass mark or "cutscore" is the minimum standard required for safe practice. RESULTS: In total, 114 candidates have completed the MCQ examination at least once, with an overall pass rate of 52% on the first attempt. Pass rates are higher from countries where dietetic education more closely reflects the Australian model. While the pass rate for each exam tends to vary with each cohort, the cutscore has remained relatively stable over eight administrations. CONCLUSIONS: The findings provide important data supporting the validity of the MCQ exam. A more complete evaluation of the validity of the exam must be sought within the context of the whole DSR program of assessment. The DSR written component may serve as a model for use of the MCQ format for dietetic and other professional credentialing organisations.

Internationally Educated Nurses in Transition in the United States: Challenges and Mediators.

International migration has doubled worldwide since 1970, and nurses are increasingly becoming a part of this trend. In 2008, approximately 5.6% of RN positions were filled by nurses educated in other countries. One of the critical issues is the transition of these immigrated nurses to the U.S. health care system and acculturation in a new society. Continuing education is necessary to promote adjustment and provide for a successful transition while ensuring quality patient care. The life patterns model provides a framework to describe the challenges and potential mediators in the transition process. J Contin Educ Nurs. 2017;48(3):139-144.

Investigating internationally educated Taiwanese nurses' training and communication experiences in the United States.

BACKGROUND: The study objective was to construct an understanding of how educational training affected the cross-cultural communication experiences of five internationally educated Taiwanese nurses in the United States. METHOD: Data collection included focus group interviews, individual interviews, and background information surveys. A combination of narrative and thematic analysis was used to analyze data. RESULTS: Findings showed that the five participants believed their education and training did not prepare them well in U.S. health care communication. The training content lacked essential language needs and cultural knowledge of patient backgrounds, hospital subcultures, hospital policies, and nursing routines. In addition, clinical shadowing was limited in improving international nurses' English communication ability and building cultural competence. CONCLUSION: Internationally educated nurses require specialized language and nursing assessment and comprehensive on-the-job training to work in U.S. clinical settings. This study benefited the VisaScreen and U.S. hospitals toward filling the training gaps of language and culture for international nurses. It also contributed to the understanding of both Teaching English for Speakers of Other Language researchers and nurse educators about the complexity of cross-cultural clinical communication.

Professional integration as a process of professional resocialization: internationally educated health professionals in Canada.

This paper examines the process of professional resocialization among internationally educated health care professionals (IEHPs) in Canada. Analyzing data from qualitative interviews with 179 internationally educated physicians, nurses, and midwives and 70 federal, provincial and regional stakeholders involved in integration of IEHPs, we examine (1) which aspects of professional work are modified in transition to a new health care system; (2) which aspects of professional practice are learned by IEHPs in the new health environment, and (3) how IEHPs maintain their professional identity in transition to a new health care system. In doing so, we compare the accounts of IEHPs with the policy stakeholders' positions and analyze the similarities and the differences across three health care professions (medicine, nursing, and midwifery). This enables us to explore the issue of professional resocialization from the analytical intersection of gender, professional dominance, and institutional/organizational lenses.

Pathways for foreign-trained dentists to pursue careers in the United States.

With the U.S. population growing ever more diverse and the need for dentists in many areas of the United States, there is increasing opportunity for foreign-trained dentists to pursue dental careers in this country. This article provides a broad overview of dental education and career pathways available for foreign-trained dentists in the United States. Educational opportunities include pursuing advanced standing dental degree programs and advanced graduate education (residency programs). Career pathways include working in academic and private practice settings. This article also describes the licensure and visa requirements foreign-trained dentists must satisfy to work legally in the United States.

International recruitment of allied health professionals to the United States: piecing together the picture with imperfect data.

BACKGROUND: Research on the international recruitment of health professionals to the U.S. has focused almost exclusively on physicians and nurses; we are aware of no research on the migration of allied health professionals. OBJECTIVE: We examined the strengths and weaknesses of various public and private data sources on foreign-educated allied health professions in the U.S. and patched together a picture of these migrants. We focus on pharmacists, physical therapists (PTs), occupational therapists (OTs), speech language pathologists (SLPs), and medical and clinical laboratory technicians (lab techs). FINDINGS: Based on the American Community Survey, we found that 12% of PTs, 12% of lab techs, 8% of pharmacists, 4% of OTs, and 3% of SLPs are foreign-born and entered the U.S. at age 21 or older. Among foreign-born PTs, about half remain as non-citizens, suggesting the highest proportion of recent arrivals among the five professions. CONCLUSIONS: As Congress debates comprehensive immigration reform, one of the much need changes to the system is better immigration data, disaggregated by occupation.