Internationalisation

The recent emphasis on globalization in healthcare education includes the importance of internationalisation as an approach for providing students with international and intercultural competence. Despite the well-cited benefits and increased internationalisation opportunities within physiotherapy education, it seems that student participation in these experiences remains quite low.

THIM University also strongly believes in the benefits of international experience for students. The aim is to give students opportunities to develop international competences and skills, in order to optimize not only their international career opportunities as a physiotherapist, but also their personal growth.

By offering international/intercultural experiences either abroad or digitally at home, THIM hands students opportunities to gain invaluable knowledge, skills, and attitudes that are essential to not only be(come) a more complete professional, but also a more active member of the international society. In today’s and tomorrow’s pan-European society, looking across borders, and thus learning new viewpoints and different approaches, gaining understanding of different cultures and making new friends and connections, is invaluable for personal and professional growth. Student mobility will enable participants to become aware of their own international and intercultural competencies that are essential in their (future) professional field and will essentially make graduates more social, integrated, and employable within Europe.

THIM strives to make internationalisation a fundamental part of the program for all of its students, be it through studying or courses abroad, short term blended mobility opportunities, or digital exchange from the home country.

Although the vision of THIM University is clearly described, THIM would like to know whether students support this vision on internationalisation. To answer this question, seven students of THIM-NL (from which three students were from an international class) and eight students from THIM-CH were interviewed by peers on this topic.

If you had the possibility to study abroad, would you take that opportunity? Why and why not?

Out of eight Swiss students, five students say that they would absolutely take this opportunity. On the other hand, one Swiss student who traveled the world before due to her job as a flight attendant, enjoys staying home now and would not consider this. Another Swiss student would consider studying abroad for a maximum duration of 2 weeks, and for another Swiss student it would depend on the timing and the country of destination. Out of four Swiss students that include preferable countries of destination, three students mention the Netherlands because there is a THIM school there, and the Netherlands being ‘well known for their high level of physiotherapy education’.

Out of four Dutch students, three would take that opportunity, of which one student indicates a maximal length of stay of 1 year. The fourth student states that it would depend on the country of destination. He would be very keen to go to America to ‘combine studying with exploring that big country’.

The three international students already grabbed the possibility to study abroad in the Netherlands. One Nigerian student explains: ‘because the educational system in the Netherlands and the level of physiotherapy is better than in Nigeria’. Although the other two students moved from their home country to the Netherlands too to study at THIM, they would also consider the possibility to study in another country than the Netherlands.

Even when keen on studying abroad for a while, they would also miss things;

- ‘I would miss my friends here, the Dutch food, my family and much more’

- ‘having grown up in the mountains, I don’t think I could be happy in a place without any significant mountains in the long run’

The most frequently cited argument for studying abroad is personal growth. Other arguments are to get to learn new people, improve social skills, improve English language skills, learn about different cultures, learn about different view points on physiotherapy and go on an adventure. To quote one student: ‘I think it is a really cool experience because when I hear other people who have been studying aboard I get a little jealous. I also think it is great for your personal growth, because there is no one to fall back on’.

How would internationalisation influence physiotherapy students, and how could this influence their job as a physiotherapist?

Students believe that there are a lot of positive influences of internationalisation. For example: ‘A semester abroad gives you the opportunity to improve your language skills, make new contacts and get to know other cultures. In addition, students learn to critically evaluate different opinions and therapeutic methods.

Internationalisation can open many doors, especially in terms of international cooperation between the top minds in their fields, but also in terms of personal and working relationships being formed

Internationalisation is therefore not only beneficial for the individual, but also for society as a whole; after all, everyone takes a part of what they have learned with them’. One student adds: ‘Although the anatomy remains the same, each country has its own methods and approaches’. This is supported by another student: ‘this can give a more eclectic approach to how physiotherapy can be done’.

One student puts things in perspective: ‘I like Switzerland, and I really like my family, but to study abroad is a good opportunity and if you have it I think you should take it’.

One student sees a role in internationalisation to help ‘standardize the practice of physiotherapy across the globe. This could make it easier to communicate with international colleagues and understand international research. It could also influence how we understand the patients culturally with regards to health, pain, and lifestyle’. Another student adds: ‘It could also create new opportunities career wise, for example teaching internationally, doing research internationally, working in different clinics across borders etc.’.

One Swiss student describes it as follows: ‘Internationalisation can open many doors, especially in terms of international cooperation between the top minds in their fields, but also in terms of personal and working relationships being formed. As for students specifically, I think it’s nice to be able to talk to people with the same aspirations and dreams as yourself and it helps to form a bigger picture about your field of study’. Students think that internationalisation during their study could make the physiotherapist more open, empathic, patient, and understandable towards patients from another culture. One student summarizes: ‘I do believe that moving to a different country, if only temporarily, provides you with a different perspective on life and your field of study. Having to overcome the challenges that inevitably come with such a relocation can help build character, increase confidence and leave you with a much more open mind for other people, cultures and systems’.

However, one student mentions that you don’t always need physical exchange to get a glimpse of physiotherapy across borders: ‘The whole process of exchanging ideas internationally is much easier and faster now due to innovations compared to ten years ago. We are able to talk to a lot of brilliant people without really leaving our country. So, you don’t necessarily need to leave your country physically to have an international experience’.

What do you expect from THIM regarding internationalisation of their students?

THIM students like the opportunity to get in contact with foreign (THIM)students. Most of them expect THIM to facilitate this contact and opportunities to study abroad for a while. To provide the best possible support and advice for students who are interested in a semester abroad: ‘The University should make the semester abroad attractive and convey to the students that this is an experience for life’.

Thereby, most students would like more projects such as this international assignment, or to do group projects together. To quote one student: ‘I expect them to give us the opportunity to link up internationally, because it is important to hear different international opinions and views’.

Most students indicate that they enjoyed the digital contact with a foreign student during this international assignment. However, they are also keen on visiting the THIM University in the ‘other’ country and meeting THIM students of that other country in person. Dutch students would also be keen on meeting Swiss students while skiing in Flumserberg in February 2023 and a Swiss student proposes THIM-CH and THIM-NL students could meet in Germany when THIM-CH students visit the dissection room in Heidelberg.

Two of the three students of the international class at THIM-NL add something important to the expectations of THIM regarding internationalisation of their students. They would expect THIM to stay updated with international guidelines.

What are the challenging parts of international study exchange compared to only being based in your country of origin?

Most students see the language barrier as the most challenging part. This is supported by an international student of THIMNL, who speaks from experience: ‘The language can be challenging, e.g., English is used in class. Language can also be an obstacle outside of school in daily life, such as talking to your landlord or looking for a hobby’.

Students also see a challenging part in missing family and friends and potentially get lonely: ‘your family and friends aren’t around to help and support you’. This is also supported by an international student:‘The challenging part of studying abroad is that you are far from home, and cannot see or hear your family in person, only through the phone’.

Several students add that a possible challenging part might be that you are out of your comfort zone: ‘being based in your country of origin of course provides many people, myself included, with a sense of comfort and security, as you already know how everything, from public transport to taxation, works’. However, ‘always staying in your comfort zone is counterproductive for personal growth’.

Being open-minded is one of the main key elements of internationalisation. How could you enhance it?

The students absolutely agree that open-mindedness is a key element in internationalisation. Students think that it can be enhanced by ‘approaching new ideas positively’, ‘inform yourself about other cultures’ and ‘expose yourself to different cultures’. One student adds: ‘sometimes you’ll be nervous for not knowing what’s coming, or you don’t know what you can expect. But most of the times afterwards you can say it was cool and you learned a lot from it’.

A good way to enjoy your international experience as a student and learn to get more open minded is summarized as: ‘try everything from the new country. Make new friends. Try to learn the language and maybe find a job so you can learn more about the country quicker. [….] Go out and have a drink on your own an try to make new friends. Find a job in a restaurant so you can make contact with people from the country and maybe learn their language and culture’.

Several students think that, to some degree, openmindedness is part of one’s personality, which might be hard to change. However, this is not impossible to change. According to one student, ‘you might get motivated to be more open-minded if you learn about the advantages of internationalisation, and what it can do for you, your practice and your career (and your patients)’. Another student adds: ‘maybe before you go to the country you are going to study, you can watch a few YouTube videos about the country and the city you will visit, so you know a bit more about it beforehand’.

Students not only think that being open minded stimulates internationalisation, but that internationalisation also stimulates being open minded. In addition one Swiss student believes that being open minded can be stimulated by ‘starting with internationalisation at the beginning of the study’.

The most important element that students name can however be summarized by the following: ‘Physiotherapists need to be extroverts, so try to become an extrovert and don´t be shy! Listen to other people, get social skills, just start conversation and be interested and curious’.

How do you see the role of e-health in the future of physiotherapy?