title: The feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries: a comprehensive systematic review.
abstract: Objectives  The objective of this review was to appraise and synthesise the best available evidence on the feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries. Inclusion criteria  This review considered quantitative and qualitative research papers that addressed the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries. Papers of the highest level of evidence rating were given priority. Participants of interest were all levels of nursing staff, nursing students, healthcare consumers and healthcare administrators. Outcomes of interest that are relevant to the evaluation of undergraduate nursing curricula were considered in the review including cost-effectiveness, cultural relevancy, adaptability, consumer satisfaction and student satisfaction. Search strategy  The search strategy sought to find both published and unpublished studies and papers, limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Finally, the reference list of all identified reports and articles was searched, the contents pages of a few relevant journals were hand searched and experts in the field were contacted to find any relevant studies missed from the first two searches. Methodological quality  Each paper was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. Results  A total of four papers, including one descriptive study and three textual papers, were included in the review. Because of the diverse nature of these papers, meta-synthesis of the results was not possible. For this reason, this section of the review is presented in narrative form. In this review, a descriptive study and a textual opinion paper examined the cultural relevancy of borrowed curriculum models, and the global influence of American nursing. Another two opinion papers evaluated the adaptability of another country curriculum models in their countries. Conclusion  The evidence regarding the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries is weak because of the paucity of high-quality studies. However, some lower-level evidence suggesting that direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. Second, the approach of considering international, regional and local experiences more feasible and presumably a more effective strategy for adapting of a country's curriculum into a culturally or economically different country.
authors.affiliation: Discipline of Nursing, School of Population Health and Clinical Practice, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Rasika
authors.initials: R
authors.lastname: Jayasekara
authors.forename: Tim
authors.initials: T
authors.lastname: Schultz