Learning "professionalism" in health science education: Toward a transcultural framework from internationally educated health professionals in Canada


Yidan Zhu, Texas State University

This research project explores how internationally educated health professionals learn professional skills, produce their own knowledge, and (re)orient their understanding of "professionalism" in Canadian health science education and higher education. In the past decade, an increasing number of internationally educated health professionals (IEHPs) have migrated to Canada to live and find work. IEHPs are internationally trained health professionals such as doctors, physicians, nurses, and midwives who received their health professional licensure outside of Canada. In Canada, close to 25.9% of physicians (approximately 18,233) were trained internationally (CIHI, 2017a). In 2016, there were 26,710 internationally educated registered nurses in Canada, representing 8.1% of the total registered nurses in Canada (CIHI, 2017b). Without a doubt, the large number of internationally educated health professionals have benefited the nation's health care system and services; however, they have also brought new challenges for both health science and higher education. One of the prominent issues is that health science education has undergone struggles in incorporating the changing contexts of the health care system into the current health professionals' education. There are tensions between the changing curriculum and educational goals, the shifting meaning of professionalization brought about by individuals with different backgrounds, and the traditional professional cultures that are deeply rooted in local higher education. Many argue that multiple conceptualizations have value that "the quest for universal definitions has failed to capture", and that health professionals should be aware of such shifted meanings and incorporate those implications into future health science education for various health professions (Kahlke and Eva, 2018). Hence, the purpose of this project is to explore the changing meaning of "professionalism" in current health science education by investigating: 1) The IEHPs' understanding of "professionalism"; 2) the professional learning experience of IEHPs in health science education/higher education; and 3) the development of professional preparation programs for IEHPs from health science educators. This study adopts a transnational theoretical framework aiming to propose a transcultural framework for promoting transformative learning in health science education. The term "internationally educated health professionals" is socially, politically, and culturally constructed. Based on that construction, immigrant professionals' knowledge and skills are unrecognized and devalued (Guo, 2009). IEHPs are usually imagined as "unprofessional" or "without any Canadian/local experience." While IEHPs try to acquire "Canadian experience" as health professionals in order to fulfil the requirements of being a qualified "Canadian health professional," there are unequal power relations between their professional knowledge and the knowledge that they need to learn in Canadian higher education. "Transnationality" has become an important framework for studying migration and mobility in the global world (Glick Schiller et al., 1992; Guo, 2013, 2016; Xiang et al., 2013). Since Glick Schiller, Basch, and Blanc-Szanton (1992) proposed "transnationalism" as a framework for studying migration, scholars have started to examine how migrants build social fields in which they link together their country of origin and their country of settlement. Debates have arisen in transnational migration studies concerning the changing meaning of "home" (Levitt, Kristen, and Barnett, 2011; Taylor, 2015), integration and assimilation across borders (Kasinitz et al., 2002; Waldinger, 2017), and the connections between return migration and transnationalism (Guo, 2016; Xiang et al., 2013). This research offers new insights that compel us to reconsider the essential debate in the study of transnational migration--the concept of transculturation. Transculturation is not a new term, it is used in cultural studies and suggests a process through which "individuals and societies chang[e] themselves by integrating diverse cultural life-ways into dynamic new ones" (Guo and Maitra, 2017). Transculturation sees cultures as fluid, and places them in constant interaction with other cultures (Guo and Maitra, 2017). This study aims to propose a transcultural framework in health science education through exploration of the changing meaning of professionalism and IEHPs' non-linear, dynamic, mixed, and fluid culture and learning experiences. Based on 10 interviews with health professionals in Canada, I argue that the transcultural framework contributes to research on health professionals learning and preparation through its three-fold impact: re-examining professionalism, fostering a just and transformative learning curriculum, and providing guidance for future research on internationally educated health professionals in adult and health professionals education.

This paper will be presented at the following session: