A partnership to develop disaster simulations for nursing students in response to climate change: description of a programme in Bluefields, Nicaragua, and Virginia, USA
Authors: Emma McKim Mitchell, Ryne Ackard, Michelet David McLean Estrada, Diana Hodgson, Anita Thompson-Heisterman, Alex S Aguirre Bonilla, Cynthia Foronda
Journal: The Lancet Global Health (2020)

BackgroundA common practice in global nursing education is short-term missions where US-based students spend a brief time in a host country with hands-on experiences with patients, but maintain a US-centric perspective. Subsequently, an exchange becomes extractive, where one group benefits. Capacity-building models are needed in global health nursing education. In 2007, Bluefields Indian and Caribbean University (BICU), Nicaragua, and the University of Virginia (UVA), USA, began a collaborative partnership. In 2018, nursing faculties in these institutions developed simulations for nursing students at both sites, focused on disaster response in the context of climate change. Bluefields, located on the Caribbean Coast of Nicaragua, is vulnerable to extreme weather events and, increasingly, communities across Virginia are also experiencing such weather events. Here, we describe the joint programme and report student responses to the pilot simulations.MethodsIn 2019, three pilot simulations were conducted with groups of BICU and UVA students in Bluefields; subsequently, simulation-based training events centred on disaster preparedness responses to climate change were integrated into curricula at both institutions. In July, 2019, faculty partnered to run the simulation with 46 UVA graduate (pre-licensure) second year students, and 36 undergraduate students at BICU. Only faculty travelled between both institutions in 2019, although student groups in both locations participated in the same simulated disaster scenarios to promote preparedness. All participants completed a pre-event and post-event survey about the simulation experience and their preparedness for a disaster scenario and also participated in group debriefing.FindingsStudents at UVA reported increased confidence related to their ability to: respond in the event of a disaster (96%); their ability to describe three important considerations for disaster response in low-resource settings (97%); and their ability to describe considerations or activities for public health nurses to support disaster preparedness before a disaster (97%). Similarly, increased confidence was reported students at BICU in these categories of 97%, 99%, and 98%, respectively.InterpretationStudents and faculty at both institutions were open to, and interested in, the focus area of disaster preparedness, and the process of learning about extreme weather events related to climate change. A focus on the simulation on the acute disaster response and the subsequent debriefing on proactive pre-disaster prevention was important for learning. This work exemplifies a process for developing best practice models in global nursing education, underpinned by nursing education research in global health and capacity building.FundingThe Jefferson Trust, an initiative of the Alumni Association of the University of Virginia.