1. Introduction
Alcohol use, which is culturally and socially acceptable in many parts of the world, creates a burden of disease, social challenges, and economic consequences for societies [1]. Exposure to alcohol during pregnancy is the #1 preventable causes of intellectual and developmental disabilities [2]. Fetal alcohol spectrum disorders (FASDs) may involve a combination of lifelong and complex behavioral effects, physical defects, and learning disabilities, in a person who was exposed to alcohol before birth [3]. Depending on the amount and timing of alcohol exposure to the in utero environment, infant growth and neurologic deficiencies may occur, with or without a characteristic pattern of facial features [4,5].
Emerging digital tools coupled with a keen awareness of the need for global cooperation, offer the potential for academic and clinical collaboration on subjects such as FASD, forging healthcare partnerships, and inter-professional education among diverse partners around the world. Distance learning may involve a wide range of technologies, and does not exclude the use of traditional lecture and learning processes [6]. Further, use of educational technology was of benefit to both teacher and learner, and found to improve digital literacy throughout an academic population [7,8]. Thus, with emerging technology and global educational opportunities, partnering institutions should consider the tools available for optimizing cognitive learning [9] and implementing educational methodology and modules for issues of clinical and scientific relevance [10].
This article on Fetal Alcohol Spectrum Disorders (FASD) describes a successful inter-professional partnership and clinical educational program between health care faculty, students, and community members; and extends the reach between two US institutions representing nursing, medicine, and family and child development; and a university in Vietnam, representing nursing, medicine, and pharmacy Table 1. Faculty at the three universities identifieda common interest in exploring the development of a mutually beneficial educational program to promote maternal child health. The specific public health issue of interest was maternal consumption of alcohol during pregnancy which may result in one or more conditions, known as Fetal Alcohol Spectrum Disorders (FASD). The case study describes an innovative educational program of evidence-based practice that incorporated technology- mediated communication and an interdisciplinary collaboration within a Pan Pacific academic partnership.
2. Methods
An educational face-to-face and virtual presentation on FASD was conducted at a US institution, utilizing a synchronous interactive presentation on site at CSUSB; with virtual interaction occurring with colleagues from other campuses in the USA, and global partners in Vietnam Table 2. Communication was first done through telephone and electronic mail over a period of a few months, as indicated in the timeline. Once the program objectives were clarified, a lecture presentation was delivered via voice over internet protocol (VOIP) from California to Vietnam Figure-1. This innovative program brought faculty from California State University, San Bernardino (CSUSB), the University of California San Diego (UCSD) Department of Pediatrics Division of Dysmorphology and Teratology, along with Tra Vinh University (TVU) in Vietnam together in February 2015. The presentation was free of charge to Tra Vinh University and was sponsored by contributions from the individual departments of CSUSB and UCSD. Faculty provided time and expertise to conduct the presentation; and the ICDFR sponsored the resources for the event. The presentation was recorded and made available for future use [11]. Future asynchronous viewing was secured as the event was recorded for dissemination in future classroom events, at the discretion of participating faculty. Another face-to-face and followup discussion (between both faculty and students representatives at participating institutions) took place on a later visit to Vietnam.
3. Theoretical Frameworks
Two theoretical frameworks were used to structure the educational program and development of the interdisciplinary partnership between the three universities Table 3. First, Pender’s well known health promotion model (HPM) was an excellent fit for the diverse cultures, disciplines, and healthcare systems. Despite differences, they all share a focus on promoting healthy behavior which can lead to positive outcomes. Pender’s HPM [12] includes the assumption that individuals can regulate their own behavior and those families, peers, and health care providers are important sources of interpersonal influence and outcomes. The theory behind the HPM is that you have personal experiences that affect your actions. The three main foci include: individual experiences, behaviorspecific knowledge and affect, and behavioral outcomes – with healthpromoting behavior as the ideal outcome [12].
The second model, Siemans’ Connectivism Learning Theory for the Digital Age [13] was used to specifically guide the flow of information about FASD and digital knowing across both countries. Specifically, “Connectivism” guided the team to follow the flow of knowledge about FASD research, health promotion, and population health to cocreate an exciting new opportunity for shared teaching and learning. Sieman’s Principles include learning as a : process of connections, diversity of opinions, function which may reside in non-human appliances, critical capacity for knowledge, nurturing experience that should be continuously facilitated; function of currency and accuracy, decision-making process; and focus on the evolving information climate [14-17].
4. Description of Resulting Change
The interdisciplinary and international event included over 200 attendees from multiple sites, and provided continuing professional education units. The use of the FASD lecture and webinar was the second in a series with Tra Vinh University, Vietnam, which then launched the ongoing educational and research exchange now in existence between these international universities. Further, the partnership with UCSD resulted in preceptor opportunities for graduate nursing students and faculty [18-20]. The event richly enhanced the CSUSB intra-campus collaboration between the Department of Nursing, the Center for Health Equity, and the Institute for Child Development. The educational program led to a presentation at a regional nursing science meeting in the United States, and a tool for implications for FASD education across the lifespan (Table 4).
5. Implications of the Project
Access to FASD and other health education topics has far-reaching clinical, preventative, and inter-professional educational benefits, with equity and access provided using a blended webinar approach. Due to the access of the internet and SKYPE tools, partners from countries with emerging programs can participate without necessarily incurring the costs of travel, and availing equitable and easy access to resources.
This initial presentation was a meaningful first step that significantly assisted all team members connect digitally, personally, emotionally and cognitively for the purpose of understanding how to change health behaviors of pregnant women who may be consuming alcohol. The opportunities for global interactions and public health need to be continually explored for nurses, physicians, children, and families.
6. Conclusion
All partners recommend a continuation of developing the partnership at deeper levels to expand the complexity, length and frequency of webinars that are financially self-supporting. We also recommend that nurse educator graduate students, clinicians, and students and practitioners in related health disciplines in California and Vietnam assume a greater role in developing the expanding collaborative efforts between disciplines, institutions, and global partners. A traditional Vietnamese proverb is: “A good beginning is half the battle,” which is reflected in this initial clinical and global educational project.
Competing Interests
The authors declare that they have no competing interests.
Acknowledgments
We thank and acknowledge the efforts of the CSUSB Institute for Child Development and Family Relations, the Institute for Fetal Alcohol Spectrum Discovery, the CSU Department of Nursing; and Châu Thị Hoàng Hoa and Lâm Vĩnh Đông of the TVU International Collaboration Office