International students’ experience of a western medical school: a mixed methods study exploring the early years in the context of cultural and social adjustment compared to students from the host country

BMC Medical Education

E. Byrne³  E. Clarke¹  R. M. Conroy³  R. Brugha³  A. McGarvey² 

[1] Health Professions Education Centre, Royal College of Surgeons in Ireland, 123 St Stephen’s Green, Dublin 2, Ireland;Anatomy Department, Royal College of Surgeons in Ireland, 123 St Stephen’s Green, Dublin 2, Ireland;Division of Population and Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephen’s Green, Dublin 2, Ireland

关键词: Social adjustment;    Internationalisation;    Acculturation;    Medical education;    Culture;    Students;    International;   

Others  :  1222287
DOI  :  10.1186/s12909-015-0394-2

 received in 2014-10-02, accepted in 2015-06-12,  发布年份 2015

【 摘 要 】

Background

Few studies have addressed the challenges associated with international students as they adapt to studying medicine in a new host country. Higher level institutions have increasing numbers of international students commencing programmes. This paper explores the experiences of a cohort of students in the early years of medical school in Ireland, where a considerable cohort are from an international background.

Methods

A mixed exploratory sequential study design was carried out with medical students in the preclinical component of a five year undergraduate programme. Data for the qualitative phase was collected through 29 semi-structured interviews using the peer interview method. Thematic analysis from this phase was incorporated to develop an online questionnaire combined with components of the Student Adaptation to College Questionnaire and Student Integration Questionnaire. First year students were anonymously surveyed online. The Mokken Scaling procedure was used to investigate the students’ experiences, both positive and negative.

Results

Three main themes are identified; social adjustment, social alienation and cultural alienation. The response rate for the survey was 49 % (467 Respondents). The Mokken Scaling method identified the following scales (i) Positive experience of student life; (ii) Social alienation, which comprised of negative items about feeling lonely, not fitting in, being homesick and (iii) Cultural alienation, which included the items of being uncomfortable around cultural norms of dress and contact between the sexes. With the threshold set to H = 0.4. Subscales of the positive experiences of student life scale are explored further.

Conclusions

Overall student adjustment to a western third level college was good. Students from regions where cultural distance is greatest reported more difficulties in adjusting. Students from these regions also demonstrate very good adaptation. Some students from the host country and more similar cultural backgrounds were also struggling. Acculturation is more complex than being associated with cultural distance and worthy of further exploration.

【 授权许可】

   
2015 McGarvey et al.

【 图 表 】

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

Fig. 5.

Fig. 6.

Fig. 7.

Fig. 8.

【 参考文献 】

• [1]Russell J, Rosenthal D, Thomson G. The international student experience: three styles of adaptation. High Educ. 2010; 60(2):235-49.
• [2]Malau-Aduli B. Exploring the experiences and coping strategies of international medical students. BMC Med Educ. 2011; 11(1):40. BioMed Central Full Text
• [3]Rienties B, Beausaert S, Grohnert T, Niemantsverdriet S, Kommers P. Understanding academic performance of international students: the role of ethnicity, academic and social integration. High Educ. 2012; 63(6):685-700.
• [4]Berry JW. Acculturation. In: Encyclopedia of Applied Psychology. Charles S, editor. Elsevier, New York; 2004: p.27-34.
• [5]Berry JW. Stress perspectives on acculturation. In: Cambridge handbook of acculturation psychology. 2006.43-57.
• [6]Berry JW. A critique of critical acculturation. Int J Intercultural Relat. 2009; 33(5):361-71.
• [7]Safdar S, Lay C, Struthers W. The Process of Acculturation and Basic Goals: Testing a Multidimensional Individual Difference Acculturation Model with Iranian Immigrants in Canada. Appl Psychol. 2003; 52(4):555-79.
• [8]Tinto V. Dropout from Higher Education: A Theoretical Synthesis of Recent Research. Rev Educ Res. 1975; 45(1):89-125.
• [9]Baker RW, Siryk B. SACQ Student Adaptation to College Questionnaire. 2nd edition. Los Angeles: Western Psychological Services. 1999
• [10]Baker RW, Siryk B. Measuring adjustment to college. J Couns Psychol. 1984; 31(2):179-89.
• [11]Rosenthal DA, Russell J, Thomson G. The health and wellbeing of international students at an Australian university. High Educ. 2006; 55(1):51-67.
• [12]Woolf K, Cave J, Greenhalgh T, Dacre J. Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study. BMJ 2008;337:a1220. doi:. http://dx. doi.org/10.1136/bmj.a1220 webcite
• [13]Woolf K, Potts HW, McManus IC. Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis. BMJ. 2011; 342:d901.
• [14]Russell J, Thomson G, Rosenthal D. International student use of university health and counselling services. High Educ. 2007; 56(1):59-75.
• [15]Dunne C. Host Students’ Perspectives of Intercultural Contact in an Irish University. J Stud Int Educ. 2009; 13(2):222-39.
• [16]McPherson M, Smith-Lovin L, Cook JM. Birds of a Feather: Homophily in Social Networks. Annu Rev Sociol. 2001; 27(1):415-44.
• [17]Niemantsverdriet S, van der Vleuten CPM, Majoor GD, Scherpbier AJJA. The learning processes of international students through the eyes of foreign supervisors. Med Teach. 2006; 28(4):e104-11.
• [18]J D, J S, A M. Tutoring international students – the importance of cultural awareness training. Educ Med. 2009,12;36.
• [19]Creswell JW, Plano-Clark VL. Designing and conducting mixed methods research, 2nd edn: Sage Publications; 2011.
• [20]Ramji H. Exploring commonality and difference in in-depth interviewing: a case-study of researching British Asian women. Br J Sociol. 2008; 59(1):99-116.
• [21]van Schuur WH. Mokken Scale Analysis: Between the Guttman Scale and Parametric Item Response Theory. Polit Anal. 2003;11(2):139–63. doi:. 10. 1093/pan/mpg002 webcite
• [22]Watson R, van der Ark LA, Lin L-C, Fieo R, Deary IJ, Meijer RR. Item response theory: How Mokken scaling can be used in clinical practice. J Clin Nurs. 2012; 21(19pt20):2736-46.
• [23]Silva J, Tenreyro S. The log of gravity. Rev Econ Stat. 2006; 88(4):641-58.
• [24]Bourhis RY, Moise LC, Perreault S, Senecal S. Towards an Interactive Acculturation Model: A Social Psychological Approach. Int J Psychol. 1997; 32(6):369-86.
• [25]Berry JW, Ataca B. Cultural Factors in Stress. In: Encyclopedia of Stress. 2nd ed. Fink G, Bruce M, Kloet ER, Robert R, George C, Andrew S, Noel R, Ian C, editors. Academic, New York; 2007: p.672-8.
• [26]Rasmi S, Safdar S, Lewis JR. A longitudinal examination of the MIDA Model with international students. Culture and gender an intimate relations. Chybicka A, Safdar S, Kwiatkowska A, editors. Gdanskie Wydawnictwo Psychologiczne, Gdansk Polond; 2009.
• [27]Hofstede G. Cultural differences in teaching and learning. Int J Intercultural Relat. 1986; 10(3):301-20.
• [28]Summers V. Students’ attitudes towards culturally mixed groups on international campuses: impact of participation in diverse and non‐diverse groups. Stud High Educ. 2008; 33(4):357-70.
• [29]Rienties B, Nolan EM. Understanding friendship and learning networks of international and host students using longitudinal Social Network Analysis. Int J Intercultural Relat. 2014; 41:165-80.
• [30]Zhou Y, Jindal-Snape D, Topping K, Todman J. Theoretical models of culture shock and adaptation in international students in higher education. Stud High Educ. 2008; 33(1):63-75.