Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)


Education/Higher Education PhD

First Advisor

Katalin Szelényi

Second Advisor

Dwight E. Giles, Jr.

Third Advisor

Patrice Nicholas


Based on demographic shifts toward more diversity and increasing health care disparities in the United States, nursing educators have been called upon to find innovative pedagogies to teach cultural competence and social justice concepts. International service-learning programs (ISL) are proliferating, as there is evidence that these experiences can promote desired competencies. However, concerns have been raised about host communities serving as learning laboratories for US students, while little attention is given to the how reciprocity and mutual benefits are achieved.

The purpose of this case study was to examine the processes, characteristics and context of partnerships formed within an innovative ISL program in nursing education, and how these partnerships support or hinder the development of reciprocity. The study also sought to investigate how issues of power and privilege were addressed, and if the sharing of burdens and benefits were equitable within the partnerships. Postcolonial theory provided the critical lens to examine issues of power, privilege, and equity within the partnerships, and revealed the lingering influence of colonial discourse.

Data were collected through interviews, participant observation, and document analysis. The sample (n=70) included host and visiting partners, US and Kenyan students, faculty, and clinicians and Kenyan community leaders who have participated in the service-learning program. Data analysis followed a constant comparative method, and two-step coding process, providing a thick description of the case and identifying the central themes.

Synthesis of study findings resulted in three theoretical models, which contribute to new understanding of the complexities inherent in establishing and strengthening cross-cultural partnerships that support reciprocity and sustainability. Four key factors, diminishing assumptions, making connections, revealing privilege, and sharing power influence partnership formation. Findings suggest that the presence or absence of five critical, interrelated behaviors support or diminish the development of reciprocity. The quality of the partnership, level of reciprocity, capacity building, and shared power affect reaching sustainability. Overall, findings from this study demonstrate that forming respectful, equitable partnerships, achieving reciprocity, and reaching sustainability are all possible. However, it takes time, as well as substantial commitment and intentional design, which raise several structural and ethical implications related to practice and policy.


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