Introduction:

Demographic changes, global health problems, advancing scientific developments in health care and recent economic crisis are key factors that contribute to the urgent need for change and reform in healthcare and healthcare issues in Europe. In response to this need, the Faculty of Health Sciences, University of Maribor, with the cooperation and help of the Faculty of Health and Medical Sciences, University of Surrey, and University College of Dublin, had organised the Summer School (SS) “Healthy living- HEALTH”. This event was sponsored under the Erasmus Programme of the Lifelong Learning Programme (European Community Action Scheme for the Mobility of University Students) Intensive Programme, for the period 2007 – 2009 and by the National Agency, the Republic of Slovenia for Mobility and European Educational and Training Programs (CMEIPUS). In this report I wish to provide an overview of the SS and three reflective accounts from three of my UK students about their experience during the SS.

The SS at the University of Maribor was attended by 13 students from Ireland, 14 students from the UK, 3 students from Portugal and 3 students from Slovenia. Speakers included local and international experts from various countries including the USA and Australia. From the University of Surrey, Professor Pam Smith and I, academic members of staff from the DHSC, Faculty of Health and Medical Sciences, University of Surrey, contributed to the SS programme. I was the UK student coordinator of this Programme.

The primary aims of this two-week Summer School were to:

• Initiate an inter-disciplinary and multisectoral knowledge exchange in principles and concepts of healthcare, healthcare informatics and other related disciplines such as law, psychology and sociology;
• Provide an overview of influencing factors and aspects of recent healthcare issues;
• Provide an understanding of the tools and methods of healthcare research and decision making;
• Provide skills and knowledge to become a proactive player in healthcare systems;
• Contribute to the formation of an international and interdisciplinary network.

Each day of the SS had a specific theme, for example, Gerontology, Psychiatry and Sociology, Simulations in Healthcare, ICT and e-learning, Community Nursing Care, Environmental, Bioinformatics and system biology, Management in Healthcare and Legal Aspects, Human Rights and Patients Rights.

Lectures were supplemented by interactive seminar sessions and visits to other interesting places, including a care home, an acute hospital, and a pharmacy in a Minorite cloister, an organic farm and a town court in Maribor. Students were also given the opportunity to have hands-on practice exercise in working groups. Assigned to groups comprising participants from at least two EU countries, students were expected to consider a specific health care issue of their choice and identify problem-solving approaches. These culminated in a poster which they presented at the end of the SS to invited guests, academics and other groups.

The first reflective account, by Fiona Brown, relates to a visit to the World Health Organisation Collaborative Centre and the Community Health centre in Maribor where they met with community nurses to learn about their work. Fiona Brown adds:

On Friday 12th June we had the opportunity to visit the community health centre and met a couple of the community nurses who worked there. I was surprised to learn that community nurses in Slovenia have a very different role to that from community nurses in the U.K. as these community nurses in Slovenia look after the whole of the family from the child to the care of the older adult while they are still living in the neighbourhood. This continuum of care from ‘cradle to grave’ along with a specific named nurse who is assigned to a district in Maribor means that there is a very good continuity of care for all age groups in the health service. The community nurses also visited people aged 65 years and over twice a year for a general health check up. This included an assessment of the older person’s Body Mass Index and mobility along with any medical and psychological problems that they may have. These bi-yearly health checks provided an ideal opportunity for the community nurse to provide appropriate advice on any health issues that they feel would benefit the older person, such as reducing the level of salt used in cooking or increasing their physical activities. These health checks are obviously an important aspect of the community nurses’ work as it allows them to have a better understanding of what the individual is able to do for themselves and whether the individual requires any extra help around the home or with specific tasks. Being a well known face in the local community, these nurses reported being able to act as an advocate for the family, for example when a family member requires additional treatment from another health service.

In the next account, Helen Herniman, also a second year student nurse, recalled:

Well, from the moment I saw my name on the selection list (for the SS) I was so excited and quickly told my family and friends jumping for joy! We all (14 UK students) made our way to the airport only having met each other briefly at a prior meeting regarding details of the SS and very soon became part of the most amazing trip and experience we could have wished for.

The intensive summer school proved to be informative and rewarding where knowledge and experiences were shared from different cultures, UK, Ireland, Portugal, Slovenia, Australia and America. 

I would just like to share a small part of my feelings after visiting a large nursing home in Maribor. My immediate thought was how staggering this nursing home was as it caters for 600 residents with varying needs; this was drastically different from any of the UK nursing homes that I have worked in where there were usually 40-50 residents. The impression I have from listening and observing the nursing home manager was that a sense of real caring is present. 

All staff wore the same uniform and for this environment I felt it very appropriate as people often can become confused with all the different roles; so this simplification meant that the residents knew quickly how to identify staff.

I was encouraged to hear that primary school children from the age of 5 years were involved with visiting older people in the nursing home and actively helped with the gardens; this certainly demonstrated the intergenerational dimension that the community nurses have in their approach to care in the community.

The nursing home organised trips, visits, picnics and barbeques. Staff also involved the residents to prepare food for functions, encouraging them to engage in healthy living and ageing. The dining hall was great and it was lunch time as we visited with music in the background, we all waved and said “ZDRAVO” (hello) I noticed a stage area which conjured up happy events that must take place.

At the entrance of the building was a bar/café that could be found as a typical sight in Maribor with many people just enjoying the sunshine and relaxing at this time of the year. I was told that family and other visits and the residents can socialize there.

My general and overall impression and feeling from this visit was despite the very large accommodation and numbers of residents this place provided a great sense of warmth; it had a happy and caring environment and I would be extremely happy to grow old in Maribor!

The final account by Hannah Young relates to her experience of learning from the SS and working with other students outside the UK. This cultural exchange has its challenges but rewards too.

I consider it a privilege to have taken part in the ERASMUS International Summer School 2009. The intensive programme made a large impact on me and I am certain that things I learnt both in and out of the classroom will influence my future career as a nurse. The lectures received were very informative and often sparked conversations regarding the variations in nursing across the different European countries represented. Frequently these conversations were continued outside of the classroom, and it was both fascinating and highly valuable to consider different models of nursing which operate in different countries. In addition to lectures we were asked to prepare and present a poster based on a health-related topic. Our group chose to address the issue of home safety for older people as we felt that many older people wish to remain in their own homes rather than moving into residential care, however a person’s home may not be the safest environment.

Within our group were some students from Madeira, Portugal. We discussed varying home safety issues for older people in our respective countries, and how these issues were being addressed. There were differences in the countries, for example, keeping cool is an issue in Madeira, whereas keeping warm tends to be more of an issue in the UK!

Initially, we found the preparation challenging as our different experiences and interpretation of the task caused confusion; however, we discovered that through open dialogue and negotiations we were able to come to agreements. Thankfully the students from Madeira spoke excellent English so there was no problem with a language barrier.

The preparation of the poster made us all more aware of home safety issues concerning older people and by working collaboratively we were able to compile a list of simple solutions to these issues from both our perspectives. Having attended the lectures, participated in the poster presentation and other activities such as visiting a care home community nursing team I now feel far more informed about nursing and especially care of older people across Europe. Through interaction with students from countries other than England, both in a classroom and social setting I feel I now have a much larger perspective on nursing and the different nursing structures and care models which will benefit my future practice and the care I provide to patients.

From the above, I can confidently argue that student exchanges such as this funded by the Erasmus programme provide such a golden opportunity for exchange of ideas, culture and learning. As an international co-coordinator of this programme with other EU partners, I have found this fortnight’s experience very rewarding and challenging, despite its intensity both in terms of content and programme. In some ways, the objectives of the SS have been met. Our students have now set up their own network to remain in contact with fellow students in this SS. The key challenge for me now is how to capitalise on my students’ new perspectives about their nursing work in terms of caring for older people and about ageing in other countries and how I could instigate changes based on these observations. If the SS can challenge our students’ perspectives about ageing, then we are one step nearer in dispelling myths about ageing. That is why I have taken this step to encourage my students to share their reflective accounts with GR.

The Summer School is supported by a European Union grant under the Lifelong Learning Programme as an Erasmus Intensive Programme, for the 2007-2009 period.

† Senior Lecturer, DHSC, FHMS, University of Surrey

* Undergraduate students, Division of Health & Social Care (DHSC), Faculty of Health and Medical Sciences (FHMS), University of Surrey, Guildford, Surrey. England