Case Study of Good T&L Practices > List of Case Studies > Internationalisation at Home Team
Team Biography
The Internationalisation at Home (IaH) team was established in 2015 – long before the onset of the COVID-19 pandemic and before the concept of IaH became more common in Hong Kong – with the vision of bringing together students from different nations, cultures, and languages. We are a five-member team with extensive teaching experience from the School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University (PolyU). The genesis of our vision began when a nursing colleague in Finland asked the team leader to consider an intercultural exchange for students from our two regions. The vision was not to follow internationalisation traditions in Hong Kong or around the world, as traditionally international students travel to other regions to learn about cross-cultural aspects in educational institutions. Rather, we wanted to explore how to better use Internet technology (such as Skype) to help our students develop intercultural communication skills in the contexts where they live and work, whether local, international, or global. This impetus gave birth to an educational initiative in 2014, followed by collaborative funding obtained in 2015 with a team of nurse educators at Malmӧ University, Sweden, then La Trobe University, Australia.
Team Head
Prof. Engle Angela CHAN
Associate Head (Undergraduate Education) & Professor at the School of Nursing,
Associate Director, International Research Centre for Advancement of Healthcare Communication (IRCAHC),
Department of English and Communication
PolyU
Inspired by narrative as a phenomenon and research methodology, Angela embarked on her own narrative journey from Canada to Hong Kong, where she is now Professor and Associate Head of the School of Nursing at PolyU. In 2005, she was selected as one of four distinguished nursing alumni abroad from the Faculty of Nursing, University of Toronto, Canada. She also served as president of the Pi Iota Chapter, Sigma Theta Tau International Honor Society of Nursing, in 2008. Her research focuses on person/relation-centred care, underpinned by the caring/human science paradigm that has evolved to emphasise effective and caring communication in health care and interprofessional collaborative practice. Her work on communication studies in education and practice has enabled her to collaborate with overseas and local colleagues to improve nursing practice and to serve as Associate Director of the International Research Centre for Advancement of Health Communication in the Department of English and Communication, PolyU. Her work in nursing education also gave her the opportunity to develop projects with international collaborators on the concept of IaH for a new type of student exchange.
Members
Dr Arkers WONG
Assistant Professor
School of Nursing,
PolyU
Dr Arkers Wong is Assistant Professor in the School of Nursing, PolyU, where he is recognised for his extensive experience in nursing education and research. He has received numerous awards for his teaching and research, including the University Grants Committee (UGC) Teaching Award, the QS Stars-Wharton Reimagine Education Awards, the Faculty Team Award for Outstanding Performance in Teaching, the School of Nursing Teaching Prize (Individual), the Faculty Distinguished Thesis Award, and the Best Research Paper Award. Dr Wong is an active board member of the Hong Kong College of Education and Research in Nursing (HKCERN), the Hong Kong Jockey Club Innovative Learning Centre for Medicine (HKJCILCM), the Pi Iota Chapter, and the Nursing Council of Hong Kong. His research interests include tele-health, mobile health (mHealth), primary health care, self-care, and health promotion and prevention.
Mr Timothy LAI
Associate Professor of Practice
School of Nursing,
PolyU
Mr Timothy Lai is Associate Professor of Practice in the School of Nursing, PolyU. He is currently Deputy Program Leader of the Bachelor of Science (Hons) in Nursing programme in the School of Nursing. His research interests focus on the use of innovative technologies in teaching. Mr Lai has received numerous awards in recognition of his outstanding contributions to teaching and research, such as the UGC Teaching Award (2023), the QS Stars-Wharton Reimagine Education Regional Collaborative Team Award 2022 – Asia Gold, the President’s and Faculty Team Awards for Outstanding Achievement in Teaching (2023) at PolyU, and the President’s and Faculty Team Awards for Outstanding Achievement in Service (2022) at PolyU.
Dr Betty P.M. CHUNG
Assistant Professor of Practice
School of Nursing,
PolyU
Dr Betty P.M. CHUNG, a graduate from the University of Sydney, Australia, works in the field of palliative and end-of-life care as a practising nurse and researcher. Her research focuses specifically on the psychosocial care of the dying and their families, family involvement in care delivery, good “quality of death”, and the well-being of older people. She has methodological expertise in qualitative interpretation and the use of a close-to-practice approach in health sciences research. The teaching and learning research projects led by Betty have secured large grants from the University-funded Areas of Excellence Scheme (AoE) and Strategic Plan Initiatives. She has received awards for her teaching and research, including the UGC Team Teaching Award (2023) and the Faculty Team Award for Outstanding Performance in Teaching (2022).
Dr Doris Y.L. LEUNG,
Adjunct Assistant Professor,
School of Nursing,
PolyU
Dr Doris Leung is Adjunct Assistant Professor in the School of Nursing, PolyU. Doris graduated and worked at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada, before joining PolyU. During this time, she taught nursing at the undergraduate and postgraduate levels and published numerous articles in several journals on research focused on palliative and end-of-life care. Today, while continuing to work with the international team and colleagues in Hong Kong, she resides in Toronto, Canada. She has expanded her research interests with colleagues “at home” and abroad, using qualitative research to explore areas of family caregiving and cultural sensitivity in health and social science education and research.
Our Internationalisation at Home (IaH) team was established in 2015 – long before the onset of the COVID-19 pandemic and before the concept of IaH became more common in Hong Kong – with the vision of bringing together students from different nations, cultures, and languages. We are a five-member team with extensive experience in teaching from the School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University (PolyU). We wanted to explore how to better use internet technology (such as Skype) to help our students develop intercultural communication skills in the contexts where they live and work, whether local, international, or global. This impetus gave birth to an educational initiative in 2014, followed by collaborative funding obtained in 2015 with a team of nurse educators at Malmӧ University, Sweden, then La Trobe University, Australia.
Why: The IaH team’s keen observations and strong motivations
As early as 2015, the IaH team realised that although more and more students were studying abroad due to the growing emphasis on the internationalisation of education, not all students had the opportunity to go overseas, due to programme logistics, time constraints, and financial constraints. The team felt that an alternative model was needed. The IaH team members believed that students could gain cultural capabilities through the use of technology in the context of IaH; that is, students could participate in international exchanges without leaving their hometown (Knight, 2006). As a result, the team developed powerful new perspectives on IaH by combining peer learning as an educational approach with student-led cross‐cultural webinars, which proved highly effective.
What: The team’s creation of a unique and alternative learning experience with lasting impact
Enhancing the nursing curriculum and training global nurses: The IaH team strongly believes that nursing students’ learning should go beyond daily practice and local perspectives, to cover global competence such as the cultural meaning, values, and beliefs of others, to practise with a holistic approach and better adapt to the globalised world.
Student-led webinars help students to realise and appreciate the similarities rather than differences between cultures and how these affect their daily clinical practices. This technique has proved effective in encouraging students to reflect deeply on their practices and identify possible ways to improve their local medical systems. The following quotes from students show the stimulating effects of the sharing sessions with their international counterparts.
Since 2015, the team has integrated the intercultural competence component into 14 subjects, involving six institutions across four countries. More than 1,100 students have benefited from this international peer learning experience. Through collaborations with universities in other countries, the work of the IaH team has had a substantial impact across borders, reaching international students of diverse nationalities and cultures.
Preparing students to accept uncertainties: The IaH team’s willingness to work with uncertainties sets a great example for students, who are encouraged and supported to embrace uncertainties and step out of their comfort zone. The team integrates the notion of coping with uncertain circumstances into various peer-learning situations. The programme has transformed the way students perceive and cope with uncertainties, as demonstrated in the quotes below.
By engaging students in dialogues and reflections on working with uncertainties, IaH activities help them stay positive in the face of the challenges of their profession. According to the University of Oxford, our changing world exhibits “TUNA1”: “turbulence, uncertainty, novelty, ambiguity”. In such circumstances, the IaH team is helping to train future leaders who are open to unknown complexities, flexible, and ready to face changes.
Producing new knowledge for the nursing field: The IaH team continues to improve its approach and practice based on new data. The design and enhancement of its cultural awareness pedagogy are based on the results of quantitative and qualitative studies carried out by the members of the IaH team. By continually producing new knowledge, improving their own work, and sharing it with the wider community, they are indeed an excellent example of the scholarship of teaching and learning, which aims to improve student learning based on the evidence collected by teachers in their teaching and learning processes and is strongly encouraged at PolyU. The team explained that “every time we discover something, we want to publish it”. Since 2016, the team has co-published nine journal articles with their collaborators and given 10 presentations at international conferences. Thus, they have widely promoted and disseminated the knowledge generated by their work internationally.
As a team, we believe that nursing students must develop intercultural understanding to meet the changing needs of our global health care world. However, the majority of our students told us that they faced logistical and financial constraints and that the opportunities available abroad were limited. Moreover, only students with high GPA scores are typically selected for the coveted overseas exchanges. These concerns and our commitment to student-centred learning based on the values of equity, diversity, and inclusiveness gave us the impetus to find an alternative to the traditional methods of internationalisation in Hong Kong.
We began to explore how our students could develop intercultural understanding through our approach to IaH activities. IaH activities apply internet technology to connect students with other students abroad and are more financially sustainable than traditional methods because they eliminate the need for international travel. Moreover, the development of cultural competence is a lifelong process (Campinha-Bacote, 2011). Therefore, we initially emphasised the idea that students should start with their own desire to become culturally aware. Cultural awareness requires that students become conscious of how knowledge is taken for granted and how they have biased assumptions about others, which they must be willing to alter or suspend (Campinha-Bacote, 2011). As Agar (2006) stated, “All we can know at first is that something we didn’t understand caught our attention. It signals a difference between us and what was going on at that moment”. These moments are reference points, signalling a “rich experience” for which we “need to question our assumptions, of what may (or may not) be shared meanings or contexts unknown to us” (Agar, 2006, p. 6). We understood that IaH activities should provide the context for students to develop intercultural learning, that is, the ability to “blend the concepts of self, strange, foreign and otherness” (Teekens, 2006, p. 17). By incorporating the unknown, IaH activities prepare our graduates to meet the challenges of an increasingly complex and uncertain world.
Characteristics of IaH activities and approach of our teaching team
We believe that students learn through intensive interactions and that intercultural competence is best achieved when there is a common purpose. Therefore, we decided to adopt an activity-based approach to IaH consisting of a series of webinars and student-led learning groups that focus on a client case based scenario. Some modifications were made to the original structure, based on the findings of our pilot study. First, a webinar was added (for a total of four) to give students more time to reflect on their learning. Second, at PolyU we collaborated with our partners from Sweden and Australia (Malmö University and La Trobe University, respectively) to develop the client case scenario. This scenario was originally paper-based and was adapted into video to add more context. Furthermore, the original discussion guide was modified to encourage students to work in teams and contextualise their problem-solving in how they, as individuals and future nurses, would integrate nursing ideals into their respective home countries.
The online IAH activities were introduced as part of the respective Bachelor of Science in Nursing programmes of the partner universities. Students were divided into intercultural learning groups, with each group consisting of two to four students from each university. During the webinars, each student-led learning group reviewed the case scenario, presented as several stages in the journey of an older client and his family, from admission to discharge in an acute hospital ward. We adopted the student-led approach so that students could be more autonomous and actively involved in sharing and enriching their knowledge. Although teachers did not participate in the webinars, they were available on Zoom (an online communication application) or by email if students had questions related to the content or encountered technical problems. The different learning groups used a semi-structured guide to facilitate discussions of how care would be managed in their respective countries in this scenario, using the nursing process and person-centred care perspectives. For example, one of the discussion questions was “What approaches should be taken to show nurses’ caring attitudes (i.e., empathy, compassion) and reflect concerns for person-centred care?” Live, synchronous discussions took place in English via Zoom.
Although our pilot study suggested that the students showed signs of growing cultural awareness (i.e., an appreciation of nursing practice in different cultures), we also found evidence of their learning about themselves as people beyond nursing students, which is essential to developing deeper cultural sensitivity (Chan & Nyback, 2015). This inspired us to explore the process of developing cultural awareness, laying the foundation for our collaborative efforts in research and international exchange between our partner institutions.
We primarily collected and analysed qualitative data (reflective journals, focus groups) for analysis, triangulating these data with quantitative data (i.e., Cultural Awareness Survey [Kumlien et al., 2020)]). The results of our studies culminated in our understanding not only how the students developed cultural awareness but also in what ways they failed to do so (Chan et al., 2017). This understanding enabled us to target key features of our cultural awareness pedagogy, applicable to how we, as teachers, can better approach cultural awareness (i.e., learner-centred with less structured interactions) and how intercultural learning and communication is enabled (i.e., shifting from factual to experiential knowledge). Our efforts culminated in the development of two conceptual models: one specific to how cultural awareness develops (see Figure 1) and the other focused on how such awareness applies to the nursing profession (see Figure 2).
Notably, achieving a “transformed understanding of nursing” involved a cyclical process of going through many stages and skills in our discussions with the students (Leung et al., 2020).
In summary, we learnt that cultural awareness was triggered by the students’ “intercultural lens”, through reflection on their “personal actions and those of others” (Carlson et al., 2017). These findings are applicable to nursing as “universal and recognisable”: the essence of nursing remains the same but can be expressed differently, highlighting the value of experiential learning to develop cultural sensitivity.
This ongoing experience has not only benefited nursing students but also improved our own ability to strengthen and influence the broader local curriculum and that of our overseas collaborators, our ability to sustain our current international collaborations, and our ability to create new ones.
We mobilised teachers locally to modify their curriculum in ways inspired by our IaH activities:
Statement of Teaching Philosophy | 2023 UGC Teaching Award
- At the School of Nursing, PolyU, between 2015 and 2023, our IaH Activities benefited more than 810 local and more than 300 overseas undergraduate students.
- An IaH activity was integrated into a service-learning subject called “Healthy Lifestyle Challenges for Developing Communities” in 2020/21 for 148 medical and nursing students from PolyU and Duta Wacana Christian University, Indonesia. Dr Patrick Kor and his team (Drs Stefanos Tyrovolas and Jing Jing Su) stated:
This programme achieved the learning outcomes by successfully enhancing students’ cultural awareness during a pandemic when outbound student exchanges were not possible. Given the importance of cultural competence in medical education, there is a need to develop a programme that promotes cultural awareness but offers more flexibility in terms of outbound mobility.
- The School of Nursing’s summer exchange programme incorporated IaH activities through a two-week online webinar for overseas and local students.
- In 2016, we piloted IaH activities in the form of five webinars on Skype or Adobe Connect for eight postgraduate research students in health and social sciences from PolyU and Malmӧ University, Sweden, to address cultural sensitivity in research. Since then, 32 local and 30 overseas research students have benefited from this work.
Impact on Partner Universities in Hong Kong
- Since 2021, our IaH activities have been added to the senior year articulation programme, with the participation of 44 students from three institutions: PolyU (N = 37), City University of Hong Kong (N = 6), and The Chinese University of Hong Kong (N = 1).
Impact on our Overseas Collaborators
Our programme has also had an impact on five universities abroad:
- Sheffield Hallam University, United Kingdom, and Hasanuddin University, Malaysia, invited us to collaborate in their undergraduate courses on Mental Health, Community/Public Health, Digital Health, Maternal/Child Health, and Leadership.
- Rural Nursing & Midwifery, La Trobe University, Australia, developed an online platform funded by Collaborative Online International Learning (COIL) in 2022 to promote IaH activities. These initiatives received a COVID Innovation Award and an Impact Award.
- The Department of Care Science, Malmӧ University, Sweden, officially recognised our shared IaH postgraduate course, “Cultural Awareness in Research Health and Social Sciences”, as a research elective in its PhD curriculum. The department subsequently received a Global Engagement Award for this initiative in 2020.
- Dr Finn, College of Medicine, Nursing and Health Sciences, University of Galway, Ireland, published a commentary titled “A global team delivering an international module on cultural awareness” in their university’s Cois Coiribe newsletter, under Views and Opinions (29 July 2021).
International Impact
We have published six articles focused on undergraduate nursing students and another three focused on postgraduate research students. Furthermore, we have disseminated our findings through more than eight international conferences and professional practice presentations, both in Hong Kong and abroad.
- IaH activities have benefited nearly 150 medical and nursing students in service learning at Duta Wacana Christian University, Indonesia, including 48 students from Hong Kong.
- Associate Prof. Kin Cheung, our colleague at the School of Nursing, piloted IaH activities with 130 senior year students from Hong Kong, Italy, Canada, and Tunisia. She stated:
The IaH initiative laid the groundwork for students to cultivate cultural awareness and participate in cross-cultural experiences. In 2021, we incorporated the IaH notion into the Senior Year Admitted (SYA) students’ project, facilitating connections with undergraduate students from abroad.
Furthermore, IaH activities are promoted on the website “Enhancement of student internationalization project, via integration of curricular and co-curricular strategies”. As of 8 September 2022, 2,318 visitors from nearly 60 countries / regions had visited the website.