An enjoyable involvement: A qualitative study of short-term study abroad for nursing students.

This study aimed to explore the experiences of nursing students who have undertaken a short course in an overseas educational system to generate theoretical understanding of the experience of studying abroad. Learning in the health professions needs to considered in the context of globalization as a way of sharing knowledge and taking responsibility as world citizens. Studying abroad provides students with an opportunity to develop global health care competencies. A symbolic interactionist approach was adopted to gain insight into how the students constructed the meaning of studying abroad. The study was conducted at a university with 2 campuses in Taiwan. A purposive sampling strategy was employed to recruit 14 participants. Data were collected from August to November 2017 via individual in-depth interviews. A semi-structured interview guide was used. Qualitative content analysis was employed to analyse the data. Each interview was audiotaped and transcribed verbatim. Most students identified both positive and negative experiences related to their professional and personal development and needs. They demonstrated motivation to leave their comfort zone and enter a challenging environment as well as a high level of adaptability. The experience enabled them to see themselves as part of the world and expanded their learning in positive ways. On completion of their course, they encouraged others to experience this enjoyable once-in-a-lifetime opportunity.

International allied health student placements: A meta-synthesis.

BACKGROUND: Increasingly universities are offering international student placements as part of the global internationalisation movement. This review sought to synthesize the findings of studies to further understand the learning outcomes described by allied health students. AIMS/OBJECTIVES: To contribute to the understanding of the learning outcomes described by allied health students who have undertaken an international placement. METHODS: A qualitative meta-synthesis was conducted. From six databases, twenty-one studies were identified and critically appraised. Data were meta-aggregated, integrated and interpreted to develop new themes, with the experiences of over 259 allied health students synthesized. RESULTS: Themes include: the intertwined personal and professional development experienced by the students; confidence and independence, relationship building, insight into culture, service provision and differences in socio-economic and political contexts. CONCLUSION: Universities offering students international placements provide their students with opportunities to achieve unique learning outcomes with significant personal and professional transformational development that cannot be replicated by local placements.

Unpacking the hidden curriculum in nursing education: clinical placements abroad.

Many Canadian nursing programs endorse clinical placements abroad. We critically examined the hidden curriculum embedded in clinical placements seeking to provide a 'global' experience. Using purposeful sampling, we interviewed a total of 18 participants, including eight faculty, eight students and two placement coordinators. Data were analyzed using initial and focused coding, supported by NVivo. After generating themes from the coded data, we adapted Hafferty's (1998) framework to further analyze the theme of the hidden curriculum. The findings illuminate how policies sustained international experience as a privileged endeavour, with restricted access based on grades. Placements incorporated little evaluation of benefits for local communities. Few resources were allocated to students for such placements, as many students paid for their placement. The institutional terms 'international and global experience' denoted interactions with cultural "Others". We recommend that nursing programs attend to hidden practices that sustain clinical placements abroad as prestigious, commodified experiences.

Global Surgery Electives: A Strategy to Improve Care to Domestic Underserved Populations?

BACKGROUND: In the United States, a shortage of general surgeons exists, primarily in rural, poor, and minority communities. Identification of strategies that increase resident interest in underserved regions provides valuable information in understanding and addressing this shortage. In particular, surgical experience abroad exposes residents to practice in low-resource and rural settings. As residency programs increasingly offer global surgery electives, we explore whether the presence of an international surgical rotation affects graduates' future practice patterns in underserved communities domestically. METHODS: We surveyed general surgery residency graduates at a single academic institution. Those who finished general surgery residency from 2001 to 2018 were included. Participant demographics, current practice demographics, and perceptions related to global surgery and underserved populations were collected. Respondents were stratified based on whether they did ("after") or did not ("before") have the opportunity to participate in the Kijabe rotation (started in 2011), defined by graduation year. RESULTS: Out of 119 eligible program graduates, 64 (53.7%) completed the survey, and 33 (51.6%) of the respondents graduated following the implementation of the Kijabe rotation. Two participants defined their primary current practice location as international. Fifteen (45.5%) in the "After" group indicated an interest in working with underserved populations following residency, compared to 5 (17.8%) of the "Before" group (P = 0.074). Furthermore, 20 (60.6%) respondents in the "After" group expressed interest in working with underserved populations even if it meant making less money. In the "Before" group, only 13 (46.4%) responded similarly (P = 0.268). Eleven (9.2%) residents rotated at Kijabe. Those who participated in the Kijabe rotation reported an uninsured rate of 36.7% for their current patient population, compared to rate of 13.9% in those who did not rotate there (P = 0.22). CONCLUSIONS: At a single institution, our results suggest that participation in an international surgical rotation in a resource-constrained setting may be associated with increased care for underserved populations in future clinical practice. These results could be due to self-selection of residents who prioritize global surgery as part of their residency experience, or due to increased exposure to underserved patients through global surgery.

Finding your feet: student participation during initiation of international clinical placements : Student participation during initiation.

INTRODUCTION: International placements challenge students to find the right level of participation, as local practices, language and time pressure may affect their engagement in patient-related tasks or team activities. This study sought to unpack the initiation process during international clinical placements with the ultimate aim to achieve active student participation. METHODS: Following a constructivist grounded theory approach, we conducted two individual interviews with 15 undergraduate healthcare students (before departure and whilst on placement). To identify emerging themes, we applied an iterative process of data collection and constant comparative analysis. Several team discussions informed further analysis, allowing us to reach a more conceptual level of theory. RESULTS: From our findings we constructed a four-phase model of healthcare students' initiation of international clinical placements, which brings into focus how the phases of 'orientation', 'adjustment' and 'contribution to patient care' build up towards a 'sense of belonging'. We identified several factors that induced active student participation in practice, such as a favourable workplace setting, opportunities for learning and a local support network. DISCUSSION: Active student participation is aimed at different goals, depending on the four phases of initiation that eventually lead to a sense of belonging and support workplace learning.

Life Satisfaction and mobility: Their associations with career attitudes, and health-related factors among postgraduates having studied in universities intra EU and outside EU.

BACKGROUND: University postgraduates' mobility towards, and outside the EU is continuously increasing, creating a competitive context in which maintaining a high life satisfaction (LS) is a public health challenge. However, the relationship between LS and its determinants among this population are under-documented. Our aims were to measure LS indicators of mobile postgraduates (Intra EU: Who pursue part of their studies in Europe; Outside EU: Who study outside of Europe) versus non-mobile (pursue their studies in Luxembourg), and to analyze the associations between LS and career attitudes, socioeconomic characteristics, and health-related factors for each group. METHOD: Six hundred and sixty-four (644) students obtained financial aid from the Luxembourgish government independent of their family's socioeconomic situation. Contacted by post, they completed an online questionnaire. Analyses included a multiple linear regression model in which only significant relationships (p < 0.05) were used. RESULTS: Three groups were created: Mobile intra EU (n = 381), mobile outside EU (n = 43) and non-mobile (n = 66) postgraduates. Health satisfaction was positively linked to LS, in all groups. Among the mobile outside EU group, majority (63.2%) were men and 57.9% did not live alone - health was the only determinant which contributed to their LS. Among the mobile intra EU, majority (57.8%) were women, and 64.3% not living alone. Autonomy and career adaptability attitudes were positively associated with their LS (b: 0.210 and 0.119, respectively), whereas the worry factor was negatively (b: - 0.153 and -0.159) associated. The non-mobile, were the oldest of the three groups. Majority (51.6%) were women, and 93.7% did not live alone. Career optimism and planning attitudes were positively correlated to their LS (regression parameter estimates (b: 0.400 and 0.212, respectively). CONCLUSIONS: Attention should be devoted to the LS of local and cosmopolitan students, as it seems to be a relevant health indicator. Overall, the farther the mobility was, the higher the postgraduates' general LS (8.5/10) was; this indicator was higher than the LS indicator for the age group 25-34 years 7.53/10 (EU-28, in 2013). University' services could promote the development of career projects and the promotion of health to enhance postgraduates' LS. University policy makers need to ensure this for all students.

College student mortality on U.S. campuses compared with rates while abroad.

OBJECTIVE: Education abroad can be perceived as riskier for student health/safety than domestic study, but little data exists to test this assumption. We investigated one facet of student safety by comparing college student mortality rates occurring during educational programs abroad with rates occurring on U.S. campuses. Methods: Two insurers provided information about the duration of education abroad experiences for 1,342,405 individuals insured over seven calendar years and details of repatriation of remains claims during that period. Mortality rates for students abroad were calculated and compared with existing data from students on U.S. campuses. Results: Students are less likely to die during study abroad experiences than on U.S. campuses. This is driven by reduced likelihood of death among male students studying abroad. Conclusions: Results can guide staff and student training and policies by providing professionals involved in study abroad with objective information about the relative risk of overseas study and causes of death.

Educating international students about medication access and usage in the US: A pilot project.

OBJECTIVE: To (1) describe an educational program for international students about medication access and use, (2) assess perspectives on the session Participants: A College of Pharmacy and Office of International Affairs at a large, public university presented on the U.S. pharmacy system during biannual international student orientation. Methods: During seven, 20-minute presentations, a facilitator discussed the role of pharmacists, defined terms, and reviewed processes. Anonymous, voluntary post-presentation surveys were analyzed to identify common themes. Results: An 86% response rate was achieved (n = 1496). Majority of students (98%) found this workshop helpful; a majority felt comfortable filling a prescription (96%) or asking the pharmacist a question (97%). More than 95% understood key terms. Common themes included health insurance and cost. Conclusions: This educational model equipped international students with knowledge to navigate the U.S. medication use system. Other universities may apply the program to prepare international visitors to access and safely use medications.

Student-reported value of a short-term service-learning trip to Nicaragua.

BACKGROUND: The purpose of this qualitative study was to assess the student-reported professional and personal value of a one-week service-learning trip to a Nicaraguan community. METHODS: Five pharmacy students who participated in a one-week service-learning trip to Jinotepe, Nicaragua were invited to participate in this study. Individual, semi-structured interviews were conducted following the trip. RESULTS: A variety of themes and subthemes surfaced, demonstrating the student-reported professional and personal value of the short-term service-learning experience. While each pharmacy student was impacted differently, common themes demonstrated transformative pharmacy student learning. These themes included recognition that every individual has a unique story that is essential to understanding how to care properly for that individual; the benefit of establishing a relationship with a community to more effectively and compassionately serve them; the importance of determining community-specific needs to ensure that service provided is beneficial; and recognition that those who are served have wisdom to offer healthcare providers. CONCLUSIONS: Short-term service-learning opportunities can provide impactful learning for pharmacy students. Established service-learning visits with a consistent host site allow for deeper and more trusting relationships, resulting in the ability to respond to the needs and requests of the partner organization in developing communities and not impose agendas. Organizers of service-learning trips must cater to the needs of the developing community to ensure that the trip is effective in providing value to the host site rather than creating unnecessary burdens and unanticipated hardship.

Measuring professional nursing value development in students participating in international service learning: A quasi-experimental study.

BACKGROUND: International service learning is becoming widely used in nursing education as a means to provide global learning opportunities as well as part of a clinical learning experiences. Concrete outcomes for these experiences have not been clearly supported in previous research. Professional nursing values are an important learning outcome for nursing students and development of professional nursing values has been found to occur through various learning experiences. Determining if international service learning experiences facilitate the development of professional nursing values can support the use of international service learning as a viable pedagogy. OBJECTIVE: The purpose of the study was to determine if there was a difference in professional nursing values development in students who participate in international service learning as part of their clinical experiences compared to those who do not. DESIGN: The research was a quasi-experimental study with a pre-test, post-test design. SETTING/PARTICIPANTS: Undergraduate students participating in one week international service learning as part of their clinical hours were compared with students who did not participate in international service learning. METHODS: Comparison of professional nursing values development between the experimental and control group was completed using the Nurses Professional Values Scale. RESULTS: The study showed the use of international service learning as part of clinical was at least equivalent in the development of professional nursing values as traditional clinical. In addition, it supported the development of professional nursing values through clinical learning overall. CONCLUSION: The use of international service learning is a viable option for clinical experiences as a means to develop professional nursing values.

Assessing attitudes of patient-centred care among students in international chiropractic educational programs: a cross-sectional survey.

Background: Patient-centred care is internationally recognized as a foundation of quality patient care. Attitudes of students towards patient-centred care have been assessed in various health professions. However, little is known how chiropractic students' attitudes towards patient-centred care compare to those of other health professions or whether they vary internationally, and between academic programs. Objective: To assess the association of select variables on student attitude towards patient-centred care among select chiropractic programs worldwide. Methods: We conducted a cross-sectional study using the Patient-Practitioner Orientation Scale (PPOS) to assess students' patient-centred attitudes towards the doctor-patient relationship. Eighteen items were scored on a 1 to 6 Likert scale; higher scores indicating more patient-centredness. All students from seven chiropractic educational programs worldwide were invited to complete an online survey. Results were analyzed descriptively and inferentially for overall, sharing and caring subscales. General linear regression models were used to assess the association of various factors with PPOS scores. Results: There were 1858 respondents (48.9% response rate). Student average age was 24.7 (range = 17-58) years and 56.2% were female. The average overall PPOS score was 4.18 (SD = 0.48) and average sharing and caring subscale scores were 3.89 (SD = 0.64) and 4.48 (SD = 0.52), respectively. There were small but significant differences in all PPOS scores by gender, age, and program. Year/semester of study within a program typically was not associated with scores, neither was history of previous chiropractic care nor having family members who are health professionals. Conclusion: This is the first international study assessing students' attitudes of patient-centred care in chiropractic educational programs. We found small but significantly different PPOS scores between chiropractic programs worldwide that did not change across year/semester of study. Scores tended to be lower than those reported among medical students. Observed differences may be related to curricular content, extent of patient exposure and/or regional cultural realities.

Impact of Exchange Stay on Alcohol Consumption: Longitudinal Exploration in a Large Sample of European Students.

BACKGROUND: Each year, more than 300,000 university students take part in European exchange programs. Besides their positive educational and cultural impacts, these programs are also reputed to immerse students in a high-risk festive context where excessive alcohol consumption is strongly present. There is thus a crucial need to evaluate the actual impact of those exchange stays on alcohol consumption. METHODS: Study abroad (n = 3,950) and local (n = 3,950) European students completed a 2-part longitudinal survey and reported their alcohol consumption before (T1) and during (T2) their exchange stay (or at the beginning of the academic year and 6 months later for local students, constituting the control group). RESULTS: During their exchange stay, individuals studying abroad showed more excessive and harmful alcohol consumption behaviors than local students, as measured by increased general alcohol consumption and binge drinking (BD) scores at T2. In particular, study abroad students under 20 years of age and performing their exchange stay in eastern Europe were the most exposed to excessive alcohol consumption and BD. CONCLUSIONS: These results constitute the first large-scale longitudinal confirmation that exchange stays indeed constitute risky contexts in which students significantly increase their consumption and present stronger alcohol-related problems. In view of the rapid and deleterious effects of alcohol consumption in young people, it is essential to promote prevention campaigns targeting this population to limit public health consequences and possible evolution toward severe alcohol use disorders.

International Surgery Electives During General Surgery Residency: A 9-Year Experience at an Independent Academic Center.

OBJECTIVE: International experiences are an increasingly emphasized feature of general surgery residency programs. In 2008, an international elective (IE) was implemented for general surgery residents at our institution. This effort was augmented by the establishment of a pathway for formal approval of IEs by the American Board of Surgery and Accreditation Council for Graduate Medical Education in 2012. DESIGN: A retrospective review of Accreditation Council for Graduate Medical Education case logs was completed. IE operative volumes were compared to home institution general surgery service volumes. An electronic survey of IE participants was conducted to assess preresidency goals, prior international exposure, overall experience on IEs, and current or planned engagement with international experiences, volunteerism, or global philanthropy. SETTING: Independent Academic Medical Center. PARTICIPANTS: Fourteen general surgery residents who participated in IEs from 2008 to 2017. RESULTS: IE locations included the Dominican Republic (9), Ecuador (1), Ethiopia (3), and Nicaragua (1). IEs were a first-time international surgical experience for 10 (71%) residents. Nine (64%) reported that they would not or may not have participated in an IE during residency had established opportunities not been available. Ten residents had graduated at the time of this study and 3 of them have participated in international service. Median case volumes were 17 cases per week during IEs compared to 8 cases per week for residents on home institution rotations. Residents were exposed to a variety of first-time operations during IEs including open cholecystectomies, gynecologic procedures, thyroidectomies for goiter, and prostatectomies. CONCLUSIONS: Incorporation of IEs into our general surgery residency has demonstrated numerous benefits. IE participation provides valuable operative experience in both volume and variety, and can be especially impactful for those who may not have elected to pursue such opportunities independently. These experiences have the potential to empower general surgery residents to invest in similar practices and acts of generosity in their future careers.

How do we facilitate international clinical placements for nursing students: A cross-sectional exploration of the structure, aims and objectives of placements.

BACKGROUND: International clinical placements provide undergraduate students with a unique and complex clinical learning environment, to explore cultural awareness, experience different health care settings and achieve clinical competencies. Higher education institutions need to consider how to structure these placements to ensure appropriate and achievable aims and learning outcomes. OBJECTIVES: In this study we described the structure, aims and learning outcomes associated with international clinical placement opportunities currently undertaken by Australian undergraduate nursing students in the Asia region. PARTICIPANTS: Forty eight percent (n = 18) of the institutions invited responded. Eight institutions met the inclusion criteria, one of which offered three placements in the region, resulting in 10 international placements for which data were provided. METHODS: An online survey tool was used to collect data during August and September 2015 on international clinical placements conducted by the participating universities. Descriptive data on type and numbers of placements is presented, along with results from the content analysis conducted to explore data from open ended questions on learning aims and outcomes. RESULTS: One hundred students undertook 10 International Clinical Placements offered in the Asian region by eight universities. Variations across placements were found in the length of placement, the number of students participating, facilitator to student ratios and assessment techniques used. Five categories related to the aims of the programs were identified: 'becoming culturally aware through immersion', 'working with the community to promote health', 'understanding the role of nursing within the health care setting', 'translating theory into professional clinical practice', and 'developing relationships in international learning environments'. Four categories related to learning outcomes were identified: 'understanding healthcare and determinants of health', 'managing challenges', 'understanding the role of culture within healthcare' and 'demonstrating professional knowledge, skills and behaviour'. CONCLUSIONS: International clinical placements in the Asia region appear to vary greatly from one education institution to the next with no clear consensus from either this study's findings or the literature on which structure, support and assessments lead to greater student learning.

Organisational barriers to the facilitation of overseas volunteering and training placements in the NHS.

BACKGROUND: Undertaking a period of voluntary work or a professional placement overseas has long been a feature of medical training in the UK. There are now a number of high profile National Health Service (NHS) initiatives aimed at increasing access to such opportunities for staff at all levels. We present findings from a qualitative study involving a range of NHS staff and other stakeholders which explored barriers to participation in these activities. METHODS: A grounded theory methodology was drawn upon to conduct thematic based analysis. Our data included in-depth, semi-structured interviews with a range of returned volunteers, non-volunteers and other stakeholders (n = 51) who were, or had been, employed by the NHS. RESULTS: There are significant barriers to placement and volunteering activity stemming from structural and organisational shortcomings within the NHS. Difficulties in filling clinical roles has a significant impact on the ability of staff to plan and undertake independent placements. There is currently no clearly defined pathway within the NHS by which the majority of grades can apply for, or organise, a period of overseas voluntary or professional placement activity. There were divergent views on the relevance and usefulness of overseas professional placements. CONCLUSIONS: We argue that in the context of current UK policy initiatives aimed at facilitating overseas volunteer and professional placement activity, urgent attention needs to be given to the structural and organisational framework within which such initiatives will be required to work.

Symposium "International Medical Students - Support Programs in Practical Application": Networking, best-practice examples and local representation.

The new project "International Medical Students" within the German Medical Students' Association (bvmd) aims at connecting local support programs for international medical students as well as the representation of their interests within the bvmd. Within the frame of this project, the first symposium "International Medical Students - Support Programs in Practical Application" took place from the 12th to the 14th of May 2017 at the Hannover Medical School (MHH). Through partaking in different workshops, 31 participants discussed the framework conditions of local work (i.e. curricula, tutorials, social offers, cooperation between faculty members and student body, legal aspects), common problems (i.e. addressing the target group, funding of support programs) and possible solutions (i.e. targeted advertisement, application for public funds). This report constitutes a summary of the results of these discussions. The feedback from the participants on the need for such a regular exchange and the format of the symposium was positive. However, there were requests for further thematic specification. Based on this feedback the next symposium is planned for 2018.

Assessing Interest and Barriers for Resident and Faculty Involvement in Global Surgery.

BACKGROUND: Multiple institutions have developed international electives and sustainable global surgery initiatives to facilitate clinical, research, and outreach opportunities with hospitals in resource-poor areas. Despite increasing interest among programs, many institutions have not successfully reached potential involvement. OBJECTIVE: This study evaluates the experiences of Yale residents and faculty, measures interest in the development of an international surgical elective, and enumerates barriers to developing or participating in these opportunities. This was performed to develop a formalized elective and assess interest and capacity for surgical global health initiatives, as a seemingly increasing number of trainee applicants and residents were expressing interest in working in resource-poor settings. METHODS: Electronic survey of Yale Surgery residents and faculty analyzed using SPSS and Graphpad Prism. RESULTS: Among residents, previous global experience correlates with current interest in international opportunities, with 100% remaining interested, and 78% of those without prior experience also expressing interest (p = 0.018). Barriers to pursuing these activities included the use of vacation time, funding, scheduling, family obligations, and concern for personal safety. Among faculty, 28% of respondents have been involved internationally, and most (86%) expressed interest in additional opportunities and all were willing to take residents. Barriers to faculty participation included funding, relative value unit target reduction, protected time, and the desire for institutional support for such activities. CONCLUSIONS: A substantial proportion of residents and faculty have experience in global health and motivation to pursue additional opportunities. The main barriers to participation are not a lack of interest, but rather needs for funding support, protected time, and institutional recognition of academic contributions. These findings are being used to develop a global surgery elective and establish long-term partnerships with international colleagues.

Risk factors for a delay in medical education: Results of an online survey among four German medical schools.

BACKGROUND: Delayed study progress in medical school is a challenging issue for the tax paying community, the faculty and the medical students themselves. Reasons for a delay might be different from known risk factors for academic difficulties. METHODS: An online survey regarding delays in the study progress and including a personality test (BFI-10) was presented to medical students from four German medical schools after completion of their 3rd year of study. RESULTS: Of 617 students, 51.2% reported a mean delay of 2.1 ± 1.5 semesters. Frequent risk factors were secondary employment (69.5%, odds ratio (OR) 1.7, p = 0.004), female gender (69.8%, OR 1.6, p = 0.007), work or study abroad (35.9%, OR 1.5, p = 0.02), a late graduation (5.9%, OR 2.4, p = 0.02), as well as support through scholarship or mentoring (19.9%, OR 1.8, p = 0.004). "Working on doctoral thesis" (11.3%, OR 1.9, p = 0.03) and structural curricular issues (36.6%, OR 0.9, p = 0.7) were frequently identified as obstacles. "Support by friends/family" was considered helpful by 24.1% (OR 1.4, p = 0.09), as well as a high intrinsic motivation (19.1%, OR 0.5, p = 0.01). In the BFI-10, students with study delay were more prone to openness and agreeableness. CONCLUSIONS: Risk factors for delay are not identical to those for academic difficulties. To decrease the risk for delays, firm curricular structures should be identified and alleviated. Intrinsic motivation is a strong impetus of study progress and additionally might be strengthened by curricular changes.

Smoking and attitudes towards its cessation among native and international dental students in Lithuania.

BACKGROUND: Dental professionals are uniquely positioned to discourage smoking among their patients. However, little is known about the role of cultural background and attitudes towards smoking in the education of these professionals. Our study aimed to compare native Lithuanian and international dental students' smoking habits, knowledge about the harmfulness of smoking and attitudes towards smoking cessation. METHODS: We conducted a cross-sectional survey of smoking and its cessation among dental students at the Lithuanian University of Health Sciences (Kaunas, Lithuania) in 2012. All Lithuanian and international dental students in each year of dental school were invited to participate in the survey during a compulsory practical class or seminar. Altogether 606 students participated in the survey with a response rate of 84.2%. Explanatory factorial analysis (EFA), multivariate Discriminant Analysis (DA) and Binary Logistic Regression (BLR) served for the statistical analyses. RESULTS: The percentages of occasional/current regular smokers were 41.1% and 55.7% (p = 0.068) among Lithuanian and international male students, and 22.7% and 22.9% (p = 0.776) among Lithuanian and international female students, respectively. The international dental students had a deeper knowledge of the harmfulness/addictiveness of smoking and held more positive attitudes towards smoking cessation among their patients than did the native Lithuanian dental students. CONCLUSIONS: The findings of the study underscored the need to properly incorporate tobacco cessation training into the curriculum of dental education. However, consideration of the cultural background of dental students in building up their capacity and competence for intervening against smoking is essential.