The Growth of International Branch Campuses and the Implications for Cross-Border Nursing Education
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Session presented on Friday, September 26, 2014: Purpose: The purpose of this proposed presentation is to provide an overview of the findings from a literature review on the global growth of IBCs, the reported challenges to operating an IBC for both the home and host country, and to explore future implications for nursing education globally in relationship to IBCs. A recent phenomenon within higher education is the growth of international branch campuses (IBCs) as a subset of cross-border education (Borgos, 2013, Knight, 2008). The movement of students from one geographic area to another, seeking the attainment of a higher education degree, has historically defined the classification of cross-border higher education. However, globalization and internationalization have spurred an increasingly complex mixture of market arrangements for the exchange of goods and services associated with higher education moving across borders (Borgos, 2013, pp.174). The growth of IBCs, as one of these evolving higher education arrangements, has changed the landscape and definition of cross-border education to include the physical movement of institutions from one geographic locale to another (Kinser, 2010). Drawing from data produced by the Observatory of Borderless Higher Education (OBHE), IBCs are found to offer a larger proportion of degrees in business fields, tourism fields, engineering fields, and in the and arts/communication fields (Lawton & Katsomitros, 2012). There are currently five international medical branch campuses in operation (Borgos, 2013, Lawton & Katsomitros, 2012). The newness and variation of IBC arrangements has produced a lack of an universally agreed upon definition of an IBC (Lawton & Katsomitros, 2012). Despite this lack of uniformity, there are some resounding common characteristics found in the literature. Crombie-Borgos (2013) noted that IBCs are commonly defined as 1) the physical movement or presence of a foreign higher education institution in a host country, 2) a degree program must be offered 3) awards for completion of a degree must be awarded, and 4) students must complete all or part of the degree at the host country campus (Lawton & Katsomitros, 2012, Becker, 2009, Altbach, 2011, Kinser, 2010). Given this definition, the OBHE and the Cross-Border Education Team at the University at Albany, State University of New York, organizations that track the prevalence of IBCs, report that there are approximately 200 or so IBCs in operation in 8 regions: Africa, Asia, Middle East, Europe, Caribbean/Central America, Australia/Oceania, South America, and North America (OBHE, 2012, C-BERT, 2014). IBCs have seen a 144 % increase between 2006 and the end of 2011, with IBCs originating from the U.S. accounting for 48% of all IBCs (Lawton & Katsomitros, 2012, Verbik & Merkley, 2006, Crombie-Borgos, 2013). It is predicted that demand for IBCs will continue to increase, as Knight (2008), predicted the demand for international education during the 25 year period between 2000 and 2025 will increase 4 fold from 1.8 million to a upwards of 7.2 million students. The proportion of these students who will be seeking educational opportunities in their home countries at branch campuses is unknown, but if similar patterns persist roughly 300,000 students will be enrolled at an IBC in 2025 (Crombie-Borgos, 2013). Methods: A comprehensive review and analysis of the literature on international branch campuses has revealed a small number of IBCs offering nursing/health science programs, such as the University of Calgary in Doha, Qatar. The implications of these types of arrangements on access and opportunity for students seeking higher education degrees in nursing are vast and uncharted. The exploration of IBCs as educational entities providing nursing education is a meaningful endeavor given the global shortage of nurses. Results: The sustainability of IBCs has been and continues to be a topic of analysis regarding the future of IBCs in the greater marketplace of international higher education. Both in speculation and through experience, researchers have explored the potential and real threats to the long term sustainability of IBCs (Crombie-Borgos, 2013). Challenges in operating IBCs often stem from the geopolitical differences between the home campus and the host country. Issues include regulatory oversight, comparable educational experiences, quality of the educational environment, maintenance of enrollment numbers, availability of faculty, monitoring of curriculum, political instability, and management of contractual arrangements between the home country campus and the host country (Altbach, 2010, Altbach 2011, OBHE, 2011, Harding, & Lamney, 2011, Wood, 2011). Growing competition in the higher education market is also a challenge IBCs face. The market for higher education will continue to grow as emerging and transitional economies grow and develop, leading to an increase demand for a range of human capital resources (Crombie-Borgos, 2013). Both local higher education entities as well as private higher education entities will seek to gain market share in student enrollments as the economies in developing countries grow, enabling more families to have the opportunity to send their children to college (Crombie-Borgos, 2013). Due to this competition and the availability of qualified applicants the literature suggests that the most widely acknowledged threat to IBC sustainability is enrollment numbers (Altbach, 2011, OBHE, 2011, Crombie-Borgos, 2013). Amidst these concerns over the sustainability of IBCs, these educational entities offer a means for many students to achieve attainment of a higher education degree and ultimately contribute their knowledge and skill to the communities in which they reside, whether it is in a local or global capacity. Specific to the building of human capital in the health professions, the availability of nursing programs and degrees at IBCs provides another avenue for countries to explore as a means to educate and eventually employee more qualified nursing professionals in their health care systems. Conclusion: The addition of IBCs as entities providing higher education degrees and programs around the world offers a unique perspective for educational leaders in nursing to consider, as IBCs can create opportunities to increase the number of prepared and qualified nurses in regions that might not otherwise have access to programs and degrees in nursing. Ironically the growth of IBCs beginning in 2006 coincided with the World Health Organizations 2006 World Health Report documenting that 57 countries faced critical health workforce shortages (WHO, 2006). The availability and numbers of nurses in the global workforce is deemed inadequate to meet the global demand of health care needs. A significant aspect of this shortage is directly related to the number of health personnel qualified to provide professional nursing care (Buchan & Calman, 2005, WHO, 2006). The shortages are found in both high and low income countries (WHO, 2006). While the maldistribution and inequity of nursing professionals exists across both developed and developing countries, the pronounced shortages of nursing professionals in developing countries poses a significant threat to the overall health and economic development of these countries (Buchan, OMay, & Dussault 2013, Dole , Braichet, & Shaw, 2009). In particular, the attainment of the Millennium Development Goals (MDGs) is reportedly in jeopardy as a direct result of the shortages of health care personnel (WHO, 2006, Dolea, Braichet, & Shaw, 2009). One of the more pressing concerns is the epidemic of HIV/AIDs in sub-Saharan Africa; the WHO/World Bank in 2003 noted that the epidemic has led to the collapse of the health care delivery system (Dolea, Braichet, & Shaw, 2009). While the establishment of branch campuses is undoubtedly complex, the establishment of an entirely new higher education program can be more complex and take years to establish. With new models of higher education programs growing the relevance to nursing education globally is the opportunity to capitalize on these educational arrangements in order to help to curb the dearth of highly educated and qualified nursing professionals, ultimately improving health outcomes in regions where access to higher education is limited.