Introduction of lectures on COVID-19in international nursing curriculum
Yasunori Oka1,2, Norimi Takata2
1

Center for Sleep Medicine, Ehime University Hospital

2Division of International Nursing, Department of Nursing, Matsuyama School of Nursing,
University of Human Environments

Abstract

has remained uncontrolled in many countries throughlate 2020.

Infection is a major area of focus in the fields ofAlthough SARS-CoV-2 infection remains a majorinternational nursing or international medicine. The

problem in some areas, the focus of attention inrecently emerged COVID-19 (coronavirus infectiousinternational medicine fields, including international

disease 2019) pandemic has revealed critical problems

nursing, has been shifting from infectious diseases toin healthcare systems as well as serious social, political,

non-infectious conditions, including psychiatric problems

and financial issues related to healthcare. Based on theand lifestyle-associated diseases. Indeed the COVID-19

supposition that healthcare providers can learn a great

pandemic has exposed a great many healthcare-relateddeal from the ongoing issues with COVID-19, we havesocial, political, and financial issues in addition to exposing

COVID-19 related materials in our 2020 international

limitations of healthcare systems per se. The issues

nursing curriculum lectures. We hoped the adjustment

revealed by the COVID-19 pandemic can be instructive

would encourage students to learn from dynamic real

for healthcare providers and students studying to become

world events. Indeed, in our experience and based

nurses and doctors. We have included COVID-19 lectures

on student feedback, we found that the educationalin our international nursing curriculum with the aim ofsupplement enhanced participating students’knowledge

encouraging students to learn from dynamic international

about COVID-19, with some students expressing

conditions relevant to infectious disease management.

interest in following up with this international issue. The
educational activities included in the presently presented
supplemental curriculum may add value to international
healthcare education.

International nursing curriculum
The Matsuyama School of Nursing at the Universityof Human Environments in Japan has an international

Introduction

nursing curriculum integrated within its four-year degree
program. In most nursing degree programs，international

Coronavirus infectious disease 2019 (COVID-19),

nursing is taught in a series of about 15 lecturescaused by the zoonotic virus SARS-CoV-2 (severe acuteadministered to students over one or two program years,

respiratory syndrome coronavirus 2), emerged in latethough some nursing programs have special departments

2019 in China before spreading rapidly worldwide.

for international nursing.

The World Health Organization (WHO, 2020) declared

The Matsuyama School of Nursing has a unique policy

the COVID-19 outbreak a global health emergency onof teaching international nursing in all four years of its

January 30, 2020, and then recognized officially that

nursing degree programs. During the first two program

the outbreak had become a global pandemic on Marchyears, all students attend 15 lectures that are each 90

11, 2020. Despite various efforts to control infection byminutes long. During the third and fourth program

governments and international associations, COVID-19years, selected students continue to attend international

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Yasunori Oka, Norimi Takata

nursing lectures, including 15 lectures in year three andwere combined with small group discussion of the lecture

8 lectures in year four. All of the international nursing

topics. Although the lecture syllabi had already beenlectures at Matsuyama School of Nursing are currently

finalized for the year, we added discussions of issues

provided by the authors of this paper (NT and YO).

related to COVID-19 to the lecture series contents,

In the first term of 2020, second and third year

especially in lectures provided by the physician instructor

students attended international nursing lectures. The(YO). We decided to include COVID-19 pandemiccontents of the international nursing curriculum lectures

issues because they relate to international nursing andfor program years two and three are summarized in

represent examples of the real-life dynamics of topics

Table 1. Third year students participating in continued

covered in the lectures.

international nursing instruction wherein the lectures

Table 1. International Nursing Curriculum

Program year two
1. Basic concepts of global health 1: Health and globalization
2. Basic concepts of global health 2: Healthcare system
3. Basic concepts of global health 3: Sustainable developmental goals (SDGs)
4. Global healthcare research 1: Public health
5. Global healthcare research 2: Human resource and social aspects
6. Global healthcare practice 1: Smoking, disasters, and traditional medicine
7. Global healthcare practice 2: Infections
8. Global health in different countries 1: Africa and the Middle East
9. Global health in different countries 2: Asia and South America
10. Global health activities 1: Project management
11. Global health activities 2: Reproductive health
12. Global health activities 3: Mental health
13. Global health related fields 1: Economy, society, and gender
14. Global health related fields 2: Legal issues
15. Global nursing
Program year three
1. Practical issues in global nursing
2. Background in world health problems 1: Poverty and peace keeping activity
3. Background in world health problems 2: Gender and female health problems
4. Background in world health problems 3: Population and aging
5. Background in world health problems 4: Child health and education
6. Background in world health problems 5: Cultural issues and immigrants
7. World health problems 1: Mental health in developing countries
8. World health problems 2: Infectious diseases
9. World health problems 3: Non-communicable diseases (NCDs)
10. International health activities 1: Environments
11. International health activities 2: Foreign residents in Japan
12. Human resources in international nursing 1: JICA and JOCV
13. Human resources in international nursing 2: Carrier design
14. International collaboration 1: Maternity health and nursing education
15. International collaboration 2: Working outside of Japan30

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Introduction of lectures on COVID-19 in international nursing curriculum

Lectures on COVID-19

occurrence with other infectious diseases in developing
countries. Ten videos derived mainly from news programs

COVID-19 issues were addressed in three of therelated to the above topics were presented in lectures

lectures attended by our second-year students (N = 67):

(Table 2), with an emphasis on understanding how thelecture 7 (Global health care practice: Infections); lecture

situation evolved over time. We organized these videos

8 (Global health in different countries 1: Africa and thewith the aim of facilitating students’understanding

Middle East); and lecture 9 (Global health in different

how COVID-19 spread worldwide and how people havecountries 2: Asia and South America). These lectures

reacted to the pandemic. In teaching the above topics, thefocused on COVID-19 as an emergent infectious diseaselecturers focused on discussing international problems

and were organized to address four major conceptual

related to healthcare, both in developed countries and inaims. Firstly, we aimed to teach basic knowledge aboutdeveloping countries. Issues discussed in detail included

infectious diseases, as scheduled in the syllabus, with thethe WHO’s functions and limitations, the importance andaddition of COVID-19 as an updated example of a newly

challenges of international collaboration, how culturaldeveloped infection. Secondly, we aimed to provide up-backgrounds underlie different attitudes toward infection,

to-date information about the emerging pandemic toand the burden of poverty in the context of infection

help students understand how COVID-19 affects peoplecontrol. Specifically, we addressed how the WHO acted

and healthcare systems worldwide. Thirdly, we aimed

in response to COVID-19, including the insufficiency of

to present pandemic-related issues in a problem-oriented

its measures with respect to preventing early spreadmanner, including how cultural differences affect people’sof the disease, an apparently delayed recognition of thebehavior in relation to COVID-19, and how politicalpandemic, the dissatisfaction of many countries with its

issues and conflicts affect its spread. Fourthly, we aimedactions, and the USA’s declaration that it was leaving theto examine how the care of patients with COVID-19

WHO. We examined how the WHO contributes to theis affected by the particular characteristics of medical

health of people in the world as well as how the WHO

systems in different countries.

may be influenced by politics and may be inadequate in

Basic infectious disease concepts, including whatthese kinds of urgent emerging events.

defines an outbreak, epidemic, pandemic, and endemic

After the lectures, students were requested to fill instatus, were taught based on a textbook (Murakami,

an attendance card with a brief free-response comment2013). Topics related to COVID-19 covered principally inabout the lecture. In these student comments, 53% of

the latter portions of lectures included: 1) SARS-CoV-2

students indicated that they were impressed with theviral properties; 2) world-wide infection expansion; 3) theCOVID-19 lesson and/or that their knowledge about

explosion of infection in Western countries; 4) the process

COVID-19 was enhanced. Additionally, 7% of the students

of being classified as a pandemic; 5) criticisms of theexpressed that they would be interested in followingWHO; 6) political actions related to COVID-19 in China;

up with this international issue. Some students told7) lockdown as a prophylactic public health measure in

the lecturers directly that the videos about ongoing

different cultures; 8) poverty and COVID-19, with a focus

COVID-19 issues were much more impressionable thanon the situation in Africa; and 9) problems caused by co-lessons based on the textbook.

Table 2. Contents of videos used in lectures.

COVID-19 deaths in Italy (News program)
WHO declaration of pandemic (News program)President Trump stops the funding for WHO (News program)President Trump declared withdrawal from WHO (News program)
Collapse of the mask “bubble” in China (News program)COVID-19 and poverty; worst combination (News program)
COVID-19 in Africa; report by a Japanese (News program)
Spreading anxiety on COVID-19 in Africa (News program)
Concerns about COVID-19 in Africa (YouTube by a freelance doctor)
Movie trailer “Outbreak” (Movie company)
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For the third year students (N = 18), COVID-19

substantially, and some expressed interest in following

information was taught in one lecture, namely lecture 8up with the issue. In the third year lecture, nearly 90% of(World health problems: Infectious diseases). In the firststudents commented on COVID-19.

portion of the lecture, information about COVID-19 wasInternational nursing textbooks emphasize that thepresented together with information about three otherprimary interest of international nursing is moving

major infectious diseases affecting populations in thefrom infectious diseases to lifestyle-related diseases andworld (AIDS, malaria, and tuberculosis) based principally

psychiatric disorders. In this context, the COVID-19

on the contents of the textbook (Date, 2016). In the latter

pandemic reminds us that paying vigilant attention topart of the lecture, the class was broken up into small

infectious diseases, especially emergent ones, is greatly

groups to discuss the threat of emerging infectious

important. There is a continuous need for nursing

diseases and each group presented their opinions toeducators to remain up-to-date on international issues,

the class. Small-group discussion was prompted withespecially on issues related to international medicine andthe following question:“How can the spread of newly

nursing. It is our view that these kinds of educational

developed infections be prevented and who can work onactivities not only enhance students’knowledge about

this problem”. Students commented on the importanceinfectious diseases, but also stimulate their interest inof vaccine and therapeutic development, the need tointernational healthcare issues.

keep vigilant attention on contagious infections, and how
individuals’can prevent contagion with their behavior.
After the lecture, students were asked to write a shortConclusioncomment about one of the diseases discussed (AIDS,Current topics related to COVID-19 were introduced

malaria, tuberculosis, or COVID-19). Remarkably, 89% ofinto our international nursing curriculum in 2020, andstudents commented on COVID-19, showing widespreadtheir introduction proved to be an effective way ofconcern about the ongoing pandemic. Some of theattracting the attention of nursing school students.

students told the lecturer that active learning about

Moreover, lectures related to COVID-19 may enhance

COVID-19 made them think more deeply about healthstudents interest in viewing international news sources.

issues around the world.

Based on our experience, we believe that flexible planningof lectures such that their contents are responsive toDiscussion

current world circumstances is an effective educational
approach, particularly in the field of international nursing.

Nursing and medical education has been disrupted
in the trying times of COVID-19. On the other hand,

References

learning from real world experiences with COVID-19

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