Global perspectives on nursing leadership: Lessons learned from an international nursing and health care leadership development program

Background: Nurses and health care professionals who practice in the global health arena must develop the leadership skills to lead interprofessional teams that direct individual and population-based healthcare, shape health policy, and develop responses to a changing environmental, socioeconomic, and technological landscape. Programs aimed at developing these skills including nurses and health professionals from low and middle resource nations are limited.  Since 2008, the Pan American Health Organization (PAHO)/World Health Organization (WHO) Collaborating Center on International Nursing at the University of Alabama at Birmingham (UAB) has offered a biennial International Nursing and Healthcare Leadership Development Program composed of: a) didactic classes; b) mentorship/coaching; c) health/service organization site visits; and d) cultural enrichment. This paper presents program evaluation data from international participants from South America and Africa (n = 69), UAB students (n = 13), faculty (n = 32), and mentors/coaches (n = 45) from programs held from 2008-2012. Implications for future programs aimed at international nursing and healthcare leadership skill development are discussed. Methods: A mixed methods approach employing investigator-designed surveys at the end of each program was used to collect quantitative and qualitative evaluation data. Questions that guided the program evaluation were: 1) What were participants’ perceptions about the extent to which objectives of the leadership classes and overall program were achieved?; 2) What were participants’ and faculty mentor/coaches’ evaluation of the mentoring/coaching component of the program?; and 3) What were participants’ and faculty mentor/coaches’ perceptions of program strengths, weaknesses, and need for change? Themes from narrative comments were identified using content analysis procedures and the NVivo9© qualitative data analysis software package. Results: Mean scores on all of the quantitative evaluation items ranged from 3.71-4.9 out of 5 possible points indicating very positive perceptions of the program and agreement that objectives had been achieved. Quantitative and qualitative findings suggest that participants were more satisfied with the mentoring/coaching component of the program than were faculty. The primary challenges identified were time limitations and communication difficulties that included both language and information technology barriers. Participants and faculty agreed that program strengths included program content and organization, the ability for cross-cultural interaction with peers, formulation of personal leadership development plans, and mentor/coach engagement. Suggestions for program improvement were aimed at providing unstructured time to allow participants to explore their host surroundings, providing sufficient breaks between classes and activities, inclusion of problem-based learning such as case study analysis, and more time allotted to mentor/coach engagement. Conclusion: The program has been successful in preparing future leaders in nursing and other health-related disciplines to better meet global health needs. The desire of program participants for more time to engage in a mentoring/coaching relationship and free time to experience the host country surroundings suggests that program length is an important influence in participant satisfaction. Even when increased costs are taken into consideration, a 3-week program duration may be more desirable than a 2-week duration. Because communication barriers contributed to participant and faculty dissatisfaction, care should be taken to ensure a basic level of English fluency for all participants if simultaneous translations services aren’t offered is recommended.