Travel Application

The School of Nursing supports student and faculty global health projects on a competitive case by case basis. If you are interested in applying for funding for a global health project, please complete the Redcap survey and funding application below. Submit completed forms to carol.c.ziegler@vanderbilt.edu.

Global Health Funding Application Form and Rubrik

[ PDF ] [ Word ]

Predeparture Checklist

Click to fill out the Predeparture Checklist (Redcap Survey)

Location of experience

Criteria 2 1 0
Safety Profile VIO approved. VIO approved w caution.

VIO not approved.

No relationship between VU and country or agency.

VU relationship with community or agency Established relationship between VU, country AND agency. VU link with agency OR country. No local engagement.
Local Agency

Invitation or documented interest in activity by host agency.

Documented permission from host country/MOH.

Informal interest of host agency and permission from host country/MOH. No formal permission.

Purpose and Objectives

Criteria 2 1 0
Course related to this experience and/or appropriateness of preceptor if clinical credit is sought Experience is required to meet course or scholarly objectives and preceptor is available and appropriate.

Experience meets course requirements or scholarly objectives but may not be required, preceptor is available and appropriate.

 

Outside of educational objectives, preceptor inappropriate or unavailable.
Role and activities of students and faculty Student/faculty activities clearly defined and appropriate. Student or faculty activities vague. Unclear and/or inappropriate activities.
Fit of faculty and student skills and activities with community needs Skills of students and faculty closely aligned with community needs. Student skills somewhat aligned with community needs, faculty skills align with community needs. Insufficient evidence of skillset- community need alignment of students and faculty.
Documentation of compliance with local licensure/practice regulations in host country Appropriate approval/licensures sought and obtained. Incomplete documentation of compliance with clear and reasonable explanation. Compliance and regulations not addressed.

Anticipated benefit to student learning and the relationship between the host agency and VU

 

Clearly defined student learning objectives and established relationship between host and VU.

 

Clearly defined student learning objectives and plan for building relationship between host and VU.

 

Unclear student learning objectives. No plan for relationship between host and VU.
Anticipated measurable health/educational-related outcomes for the local population Benefit to community clearly defined in objectives and is measurable. Community benefit proposed and attempt to measure benefit proposed. No community benefit OR unclear value to community in objectives.

Plan for sustained involvement and continuity of program after departure

 

Clear plan for long-term involvement and investment in local host. Plan for sustained communication/relationship between host and VU.

Plan for continued relationship between VU and host exists, but plan for sustainability of project is vague.

 

No plan for sustainability of relationship between host and VU or project discussed.

 

Faculty involvement

Criteria 2 1 0
Need for faculty presence Oversight necessary. Oversight beneficial. No faculty oversight necessary.
Faculty role & scope of practice Faculty role clearly defined and within scope of practice. Faculty role generally defined and within scope of practice.

Faculty role unclearly defined and/or outside of scope of practice.

 

Relationship to curriculum Relates to course objectives. Minimal relationship of faculty with course. No relationship of faculty with course.
Collaborative value Plan to enhance or strengthen relationship between host agency/country and VU clearly defined. Plan to explore relationship between host agency/country and VU clearly defined. No plan for collaborative development.

Preparation (Students and/or faculty)

Criteria 2 1 0
Knowledge of the country and its culture Participants have previous experience in country and a relationship with agency, and have completed related coursework.  Participants may have experience in country OR relationship with agency and have had minimal coursework preparation through standard VUSN curriculum. Participants have no experience in country and no relationship with agency and have had little to no preparatory coursework.
Pre-Departure Modules Available and completed. Modules not available Modules available, not completed
Language Proficiency including need for translation and how that will be addressed Participants proficient in language of local population. Participants plan to increase language proficiency prior to travel or have plans to supply their own interpretive services. Participants lack proficiency in local language. No plans for improving proficiency. Plan to rely on local host for interpretive services.
Community needs assessments Community needs assessment complete, or planned as part of proposal. Match between participant skillset and community needs clearly defined. Match between participant skillset and community needs defined. Community needs assessment incomplete. Mismatch between participant skillset and community needs or match unclearly defined. No community needs assessment.
Evidence of alignment with local/national health care priorities or Ministry of Health objectives Clear evidence of alignment between project goals and local health priorities as defined by a local government agency. Project goals align with WHO health objectives, but no evidence of alignment with local priorities. No evidence of alignment between project goals and local or international health priorities.

Scholarly Value

Criteria 2 1 0
IRB IRB approval not necessary or IRB approval obtained. IRB approval obtained or unnecessary. No IRB approval obtained.
Plans for dissemination of participant experiences upon return Clearly defined plan for knowledge dissemination with local agency, VUSN community and nursing profession at large
And learning objective analysis completed upon return.

Limited plan for dissemination to local or greater nursing community but plan for dissemination of experience to VUSN defined. Learning objective analysis completed upon return.

 

No plan for dissemination of knowledge or experience. No analysis of learning objectives completed upon return.
Plans for dissemination of project impact analysis upon return Clearly defined plan for dissemination of quantitative and qualitative impact on the community related to project objectives (quality of life, physical/mental health, environment, population health outcomes, etc.), and impact analysis completed upon return*. Plan for dissemination of qualitative impact on the community, impact analysis completed upon return*. No defined plan for dissemination of impact analysis or impact analysis not completed upon return*.

Budget

Criteria 2 1 0

Use of funds

 

Use of funds clearly outlined and appropriate. External funding sources identified. Cost of experience is justified by proposed impact.

Use of funds appropriate but minimally outlined, no external funding sources or matched funds. Cost of experience is somewhat justified by proposed impact.

Unclear or inappropriate use of funds. No external funding sources identified. Cost of experience is not justified by proposed impact.

Criteria 2 1 0