title: The impact of international placements on nurses' personal and professional lives: literature review.
abstract: OBJECTIVE
  This paper presents a critical review of research literature on the impact of international placements on the lives and practice of nurses.
  
  
  BACKGROUND
  Health care institutions are progressively more aware of the need to respond to diverse patient populations and cultivate leaders to enrich the nursing profession, both locally and globally. One response has been to establish international exchange programmes for nursing students to give them experience of different cultures and health care systems.
  
  
  METHODS
  A search of the literature from 1980 to 2003 using electronic databases was undertaken using the databases CINAHL, ERIC, British Nursing Index, Web of Science, the BIDS Social Science Citation Index and Medline. The keywords used were 'international exchange experience', 'international studies', 'international education', 'international placement(s)', 'exchange programme(s)', combined with 'nurses/nursing', combined with 'evaluation', 'practice', 'education' and/or 'policy'. The papers retrieved used both qualitative and quantitative approaches and were scrutinized for recurring themes.
  
  
  RESULTS
  Nurses reported significant changes in their personal development, perspectives on nursing practice and critical appraisal of health care systems. They also indicated an increased appreciation and sensitivity towards cultural issues and cross-cultural care. Moreover, differences in placement programmes, such as duration, preparation and debriefing were found to have affected the reported overall international placement experience. However, the primary effects of international placements were identified as personal development and transcultural adaptation.
  
  
  CONCLUSIONS
  Students should be exposed to a variety of nursing experiences within the host country. This would give them a broad spectrum for comparisons between cultures, nursing practice and health care delivery in those cultures. Therefore, educational institutions are strongly encouraged to provide opportunities for students to participate in nursing care and education in another country.
authors.affiliation: Research Officer, School of Health Science, University of Wales Swansea, Swansea, UK. l.a.button@swan.ac.uk
authors.forename: Lori
authors.initials: L
authors.lastname: Button
authors.forename: Barbara
authors.initials: B
authors.lastname: Green
authors.forename: Cassam
authors.initials: C
authors.lastname: Tengnah
authors.forename: Inez
authors.initials: I
authors.lastname: Johansson
authors.forename: Christine
authors.initials: C
authors.lastname: Baker
mesh_terms: D003071:Cognition; D003469:Culture; D004506:Education, Nursing / Q000379:methods*; D006296:Health Services / Q000592:standards; D006801:Humans; D007393:International Educational Exchange / Q000639:trends*; D009726:Nurses; D017009:Professional Autonomy; D011361:Professional Competence; D011364:Professional Practice / Q000592:standards; D013338:Students, Nursing; D016746:Transcultural Nursing / Q000379:methods*