College of Nursing and Health Sciences PhD Doctoral Dissertation Defense
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College of Nursing and Health Sciences – PhD Dissertation Defense
Kerry Richardson
Date 3/6/2026
Time: 11:30AM – 1:30PM
Place: LIB 314 / ZOOM (Please contact dhoffman@umassd.edu for link)
Chair: Maryellen Brisbois, PhD, RN, PHCNS-BC
Committee: Mary McCurry, PhD, RNBC, ANP, ACNP and Danielle M. Leone-Sheehan, PhD, RN
Title: The Impact of a Global Service-Learning Immersion Experience on the Efficacy of Caring and Professional Nurse Values Development Among Nursing Students in the United States and Portugal: A Mixed Methods Study
Abstract
Background: Caring is recognized as a critical core value by leading nursing organizations, international public health organizations, and the American Association of Colleges of Nursing. The profession of nursing is guided by ethical standards set forth by the American Nurses Association in the Code of Ethics for Nurses. These ethical standards illustrate how professional nurse values facilitate one’s nursing practice with compassion and respect for the inherent dignity of individuals. Caring is considered to be the essence of nursing. However, caring in nursing is being threatened by factors such as the persistent nursing shortage, high turnover rates of new graduate nurses entering the profession, advancements in technologies, and increased workloads and patient acuity in a complex global healthcare landscape. Nurse educators play a critical role in promoting opportunities, through innovative teaching strategies, for baccalaureate nursing students to develop caring attributes, caring competencies and professional nurse values in the future provision of safe, high quality, patient-centered, culturally competent care. Research indicates nursing education institutions have embraced service learning as an experiential teaching strategy. Global service-learning integrates experiential learning, international exchange, and community service into undergraduate nursing curricula. There is an identified paucity in the nursing literature exploring global service-learning as a pedagogical approach to fostering caring and professional nurse values development among nursing students. Ensuring graduates comprehend and internalize the significance of nurses' caring efficacy and caring behaviors in the development of therapeutic nurse-patient caring relationships is critical and has the potential to enhance patient care outcomes, nurse job satisfaction, and nurse retention in the profession.
Purpose: The purpose of this study was to explore the impact of a global service-learning immersion experience on the caring efficacy and professional nursing values development among junior nursing students in the United States and Portugal.
Method: An explanatory sequential mixed methods study was employed to investigate whether participation in a global service-learning immersion experience resulted in significant changes in participants’ caring efficacy and professional nurse values scores, as measured before and after the two-way student exchange. A convenience sample of junior nursing students from the United States and Portugal (n = 21) completed two online surveys pre and post exchange and one open response self-reflection question post exchange. Descriptive statistics, Wilcoxon Signed Rank, and Paired t-tests were used to analyze the data. Thematic analysis was conducted on the students’ self-reflective responses to determine if students could connect their global service-learning exchange experience to Watson’s Caritas Processes and to the essence of caring and professional nurse values. The quantitative and qualitative findings were then compared and merged to identify if any relations among the data strands were present.
Results: Among the students surveyed, a statistically significant increase was observed in the pre-test and post-test score of the Caring Efficacy Scale (p = 0.045). The NPVS-3 Scale total post-test score was non-significant, however, there was an observed increase in the pre-post scale mean results; 114.44 (SD = 15.78) and 118.94 (SD = 9.46) respectively. Additionally, data analysis of the three NPVS-3 Scale factors was conducted. The “Caring Factor” post score was observed to statistically significant ( p < 0.001) and the "Professionalism Factor” post score was also, statistically significant (p = 0.040) post exchange. Mixed methods data integration of the quantitative and qualitative findings demonstrated strong convergence explained through a central theme of Transformative Experience. Participants described a shift toward a humanized, holistic approach to patient-centered care characterized by confidence, dignity, trust, empathy, presence, respect, patient advocacy, and cultural awareness. Experiences related to professional identity, ethical practice, and cultural competence further elucidated gains in professionalism and caring values.
Conclusion: This study demonstrates that participation in the “Bridging the Atlantic” immersion experience fostered meaningful transformation in students’ perspectives and strengthened their understanding of caring and professional nurse values essential to compassionate, culturally competent nursing care. Integration of qualitative findings with improvements in Caring Efficacy and NPVS-3 Caring and Professionalism factor scores revealed a strong theory to practice connection aligned with Watson’s Theory of Human Caring and Mezirow’s Transformative Learning theory. Collectively, these findings underscore the importance of global service-learning immersion experiences in nursing education to promoting compassionate, ethical, patient-centered care, for a globally informed nursing practice.
Library 314
: ZOOM
Deanna Hoffman
5089106487
dhoffman@umassd.edu