International collaboration in nursing research: Lessons learned

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As nurse scientists and professionals, we are all experiencing the globalization of economics, information, travel, technology, and health care. My recent experiences as a Robert Wood Johnson Fellow led me to create a transcultural leadership institute. This project was implemented with nurse colleagues in China and involved collaboration for nursing research and practice. Through this experience, I gained insights about the strengths of communication, culture, and collaboration—components of successful research partnerships locally, nationally, and globally.

Communication. Language is a challenge, yet it serves as a key component of successful partnerships. Few American nurses are fluent in other languages and thus often require translators. In my own international work, nurses and physicians who were fluent in English provided translation for presentations, workshops, and social events. Using PowerPoint and visual presentations was most helpful in enhancing the communication process. These formal presentations can be sent to colleagues in other countries before the formal visit and translated ahead of time. Communication is challenged by translation. To prevent lost-in-translation experiences, clear messages must be expressed and confirmed. In many cultures, people prefer to save face rather than admit that they do not understand. Thus, it is important to validate what you think you hear and ask the other participants to explain their understanding. If you make a mistake, have a sense of humor and take it in stride. E-mail has become a universal method of electronic communication. It enables colleagues around the globe to collaborate in many professional arenas across cultures and time zones.

Culture. International work of any type highlights the influences and importance of culture. Unlike borders that have clearly defined boundaries between nations, culture is instead blended around the world. As components of culture, politics and values pose other challenges. It is essential not to criticize others' beliefs or political or cultural values. It is important to listen rather than just defend one's own views. Culture also includes participating in customs, which often strengthens socialization. These cultural experiences can include visits to important historical and cultural sites in other countries. During international travel, participation in cultural events is critical, even when one is tired or would prefer to simply focus on the scholarly activities.

Collaboration. To build a true partnership, it is important to identify the strengths of all participants and use these as the foundation for future work. Global collaboration in research is enhanced if goals are clearly defined and agreed upon and if partners commit to acknowledging the contributions that each partner will bring to project completion.

Successful international work begins and ends with partnerships. Essentially, international collaboration is about relationships, networking, and connections. Through my transcultural leadership institute, I am connected to nurses in Wenzhou, China, who are leading major health care projects. After publishing reports of my international work, I have been contacted by several nurses from the United States and have connected Chinese and American nurses who are working in similar specialties. Two projects have already resulted in joint presentations, one of which has resulted in a collaborative research project. International nursing requires knowledge of one's own culture and others' cultures, risk taking, and building bridges. It is invigorating and at the same time requires tireless energy. In the end, success of international work is all about relationships and enjoying the journey!