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Internationalization, Social Transformation and Global Citizenship: An Evaluation of Global Health

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Title: Internationalization, Social Transformation and Global Citizenship: An Evaluation of Global Health


1
Internationalization, Social Transformation and
Global Citizenship An Evaluation of Global
Health
  • Lori Hanson, M Sc. PhD (candidate)
  • Department of Community Health and Epidemiology,
    College of Medicine, University of Saskatchewan
  • Madeline Johnson MSc (candidate)
  • Research Assistant

2
  • What are the curriculum implications of adopting
    a social transformational model of
    internationalization?
  • What do we know and what might we learn from
    Global Health as an example? Does it work? How?

3
Why does it matter?
  • In the worlds richest countries, the income gap
    between the top and bottom quintiles sits at a
    ratio of 741, a change from the 601 ratio in
    1990 and an incredible jump from the 301 ratio
    30 years earlier (Global Health Watch, 2005).

4
Why does it matter?
  • In health, the gap between developed and LMIC
    countries mirror this trend. The gap in child
    mortality, for example, increased from a 10-fold
    to 14-fold difference between 1990 and 2000
    (Victora, 2005) and with the global spectrum of
    poverty-related diseases such as HIV/AIDS, there
    is now an alarming 48 year discrepancy between
    life expectancy in the richest and poorest
    nations on earth (Marmot, 2005).

5
Outline
  • Background and concepts (as we are
    operationalizing them)
  • Internationalization Three Models
  • Social transformation, Social Accountability and
    the College of Medicine at the U of S
  • Global Citizenship
  • Transformative Learning
  • The Class Evaluation Global Health and Local
    Communities Issues and Approaches and Global
    Health II Selected Issues in Nicaragua
  • Methods, Results, Lessons learned
  • Implications for Internationalizing Curriculum
    in ST Model

6
Background
  • Internationalization
  • Market Model
  • Liberal Model
  • Social Transformation Model
  • (Warner, 1991)

7
Internationalization in the COM
  • Social accountability vision of medical schools
    (WHO, 1995 Health Canada, 2001)
  • Internationalization would support
    inter-disciplinary teaching and research
    approaches that seek socially just and
    sustainable solutions to the North-South divide
    in health
  • a reciprocal process, where communities and
    institutions locally and internationally seek to
    share insights and knowledge and to learn from
    the experience, cultures and research of each
    other
  • Ultimately, internationalization was to foster
    personal and professional development of capable,
    globally responsive and caring citizens.
    (College of Medicine Integrated Plan 152).

8
Global Citizenship
  • Citizenship is as much about obligations as it is
    about rights... (Byers, 2005)
  • A global citizenship perspective involves not
    only recognition of global interdependence, but
    also awareness of and commitment to societal
    justice for marginalized groups, grassroots
    empowerment, nonviolent and authentic democracy,
    environmental care, and North-South relations
    based on principles of equity, respect and
    sharing" (Toh, 1996 185).

9
Global Health and Local Communities Issues and
Approaches
  • Sr. undergraduate inter-disciplinary class of
    CHEP created by activists and academics 9 yrs
    ago
  • Topics global health issues, population health,
    people-centered development and primary health
    care etc. focusing on local global links
  • Transformative learning methods used
  • Participatory learning methods
  • Community Volunteering for academic credit
  • Simulation of Praxis (reflection-action-reflection
    cycles)
  • Facilitator vs. Lecturer

10
Global Health II Selected Issues in Nicaragua
  • six ten week experiential field study
  • Similar topics and structure, but in-depth focus
    on Nicaraguas particular health and development
    trends and issues
  • cycles of active and experiential learning, and
    reflective sessions
  • volunteering with community organizations and
    NGOs (can extend for one month)
  • Immersion in rural community

11
The evaluation
  • Questions
  • In what ways is the personally transformative
    potential of GH and GH II a) discussed /
    identified and b) manifest by students who have
    graduated from the class?
  • How do GH and GH II contribute to global/local
    citizenship?
  • What elements of the classes appear to matter
    most?
  • Methods Focus Groups, written surveys, follow-up
    class evaluations by RA
  • Participants gt one year since graduating from
    class

12
The evaluation findings
  • 1) Personal Transformation
  • the most valuable part of this course is not
    what we read or what we hear. It is the
    encouragement to improve our skills of critical
    analysis and reflection, to not accept everything
    at face value and to dig deeper to find the
    underlying reasons why things are the way they
    are.
  • The course really taught me to keep things in
    perspective Also that it is OK to not know the
    answer etc. It is important to take the time to
    reflect.
  • The class helped me to not feel self conscious
    or shy about advocacy this helped give me more
    confidence personally.

13
The evaluation findings
  • 2) Global Citizenship inward and outward
    dimensions
  • by making volunteering with local NGOs a part of
    the class requirements -- That really did break
    the cant participate barrier for a lot of
    people.
  • I was apprehensive at first, but now I have lots
    of experience. It began a huge line of
    volunteerism for me.
  • The class was the first impetus to evaluating my
    role as a global citizen. I realized the world
    is here Saskatoon too.

14
Connections
  • If we see profs live out their philosophical
    stances, this makes a huge impact. This prof did
    not set herself up at a higher level than her
    students... I saw her as a fellow learner She
    encouraged participation in class which
    overflowed to participation in Saskatoon
    communities.
  • I manifest my values on a daily basis. I try to
    reduce harm socially and environmentally and help
    others do the same.
  • I found a new way to look, a new perspective. It
    opened up my eyes to differences and similarities
    between somewhere else and here. I realized you
    dont have to go away to have an impact.

15
Implications
  • There is just too much information out there
  • The university should serve communities through
    outreach and engagement the U of S is
    recognizing this with their foundational
    documents they are trying to go in this
    direction but it should filter through the
    whole university system classes, research,
    experiences, volunteerism, professional
    development. These classes are a great example
    of what the university is trying to do service
    learning, community speakers/perspectives, making
    connections.
  • For the instructor It takes a lot of energy to
    be participatory in the class. It takes far more
    teaching time and focus to do that. Its always
    a new experience. You cant just give the same
    lecture over again. So I think its a lot more
    challenging. They the university dont allow
    time. You have to go crazy above board its
    hard.
  • Professors should spark you to think, but the
    older profs on tenure teach in the old school
    style of just a paper and an exam this promotes
    students who are unthinking and unquestioning
    consumers

16
Take Home Messages
  • Internationalization of global health
    curriculum ought to be about more than adding
    global examples - it can ought to be
    transformative
  • We can foster global citizenship (where that
    caring community-involved critically aware
    citizens)
  • Transformative Learning Theory offers potential
    as a strategy for personal and social
    transformation and a way to help students
    (re-)make needed connections.
  • Universities need to support innovation in
    teaching and learning strategies to keep pace
    with growing global health needs, growing global
    disparity and growing interconnections

17
But how?Participatory education and
Transformative learning/ed
  • Social change education is NOT
  • Banking education (Freire)
  • Neutral
  • Only about structural changes, but also personal
    / cultural change
  • TE addresses the other side of the coin, direct
    intervention by the educator to foster the
    development of the skills, insights, and
    especially dispositions essential for critical
    reflectionand self-reflectionon assumptions and
    effective participation in critical-dialectical
    discourse (reflective judgment)essential
    components of democratic citizenship (Mezirow,
    2003)
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