Preparing nurses for global health care.

In 2009, the World Health Organization published a document proposing global standards for the initial education of professional nurses and midwives, and noted that although nearly 35 million nurses and midwives make up the largest cadre of health care workers globally, they are rarely involved in high level decision-making and policy development (1). The development of the standards addressed one of the goals of the WHA59.23 resolution adopted in 2006 (2) , to develop global nursing education standards as a strategy for strengthening nursing and midwifery in order to achieve the Millennium Development Goals (MDGs) for health (1,3). The standards specify that graduates of initial nursing and midwifery educational programs should be culturally competent, have an understanding of the social determinants of health, and have the ability to practice and meet population health needs in the health care systems of their respective countries (1). The standards do not explicitly address the need to prepare nurses who have competencies in global health. In this era of increased geographic mobility, the emergence of emerging infections that cross national borders, technological and communication advances, and the growing interdependence of the world, there is a need to move beyond a focus on local and national health care problems to ensure that all nurses are prepared to address local, national, and global health needs (4-7). Global health has been defined as " …an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. Global health emphasizes transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population based prevention with individual-level clinical care " (8). Although there have been numerous efforts to define cultural competencies to be integrated into nursing curricula (9-11) , efforts to identify and define global health competencies are just beginning. It is important for nursing educators to develop innovative curricula to prepare nurses for roles in a global society (12). Specific global health concepts to be integrated into basic nursing educational programs include: global citizenship, have recently collaborated on a project to survey nursing faculty in North America and Latin America to identify their perceptions of global health competencies that should be included in basic nursing curricula (14) The survey instrument was developed by adapting a set of global health competencies for medical students that …