Cross-Cultural Ethics Learning: Taiwanese and UW Bothell Nursing Students Together in the Classroom

On a beautiful summer day, a group of nursing students from Taiwan joined an ethics class that undergraduate nursing students in the RN-to-BSN program at the University of Washington (UW) Bothell were taking (Photo 1). 

Dr. Ko Niitsu, Associate Professor in the School of Nursing & Health Studies at UW Bothell, who is the course instructor for BNURS423: Ethical and Quality Nursing Care, facilitated introductions among Taiwanese and UW Bothell nursing students and three presentations by Taiwanese nursing students.

First, Chih-Tung “Jenna” Li and Feng-Chun “Aurelien” Chiu, undergraduate students from the National Taipei University of Nursing & Health Sciences (NTUNHS), delivered a presentation titled “Sharing of Nursing Education and Health Care System in Taiwan” (Photo 2).

Second, Li-Ching “Claire” Huang and Jia-Ru “Jeyia” Chou, who are both undergraduate students enrolled at NTUNHS, described slides titled “Healthcare and Nursing in Taiwan: Systems and Ethical Dimensions” (Photo 3).

Third, Chia-Yu “Bella” Wang, a master’s student from the National Defense Medical University (NDMU), talked about “Inside a Taiwanese Emergency Department” (Photo 4).

Those Taiwanese nursing students introduced nursing education, healthcare systems, ethical concerns, and cultural influences on medical decisions in Taiwan to UW Bothell nursing students. For example, Jenna and Aurelien introduced their nursing education pathway: junior college for five years and a technical program for two years to earn the bachelor’s degree that they are currently enrolled in. Claire and Jeyia added that Taiwanese culture is rooted in Confucian Collectivism and Relational Autonomy and described how filial piety influences medical decisions in Taiwan. Bella explained Taiwan’s National Health Insurance and discussed strengths (e.g. low and predictable patient costs) and challenges (e.g. high patient volume) of the healthcare system in Taiwan from Emergency Department perspectives. Their presentations were followed by very active and lively Q&A sessions. For example, although both Taiwanese and UW Bothell students are in the RN-to-BSN program, UW Bothell students learned that the educational pathways are different between Taiwan and the United States. They were also surprised by how affordable an ER visit in Taiwan can be (i.e., about $20).  

After the presentations, each Taiwanese nursing student had an opportunity to individually answer questions that UW Bothell students asked (Photo 5).

Taiwanese nursing students talked not only about nursing-related issues but also about fun topics, such as their hobbies, restaurants they liked in Seattle, and so forth. They also casually interacted with UW Bothell students and the instructor during the break (Photo 6).

Dr. Tsae-Jyy “Tiffany” Wang is the Vice President and Distinguished Professor at NTUNHS. She is a graduate of the UW Seattle PhD program and has been bringing groups of nursing students to UW for the past few summers as their study abroad program. Dr. Basia Belza, de Tornyay Endowed Professor in the School of Nursing at UW Seattle and Director of the de Tornyay Center for Healthy Aging, was her advisor and warmly welcomed those Taiwanese nursing students, joined by other faculty members at the UW Seattle School of Nursing (Photo 7).

Taiwanese nursing student reflected on their experience visiting a nursing class at a higher education institution in the United States.

• Chih-Tung “Jenna” Li: “Visiting the nursing ethics class at UW Bothell was a valuable and inspiring experience. I enjoyed discussing nursing-related topics with the UW Bothell students and learning about their perspectives on ethical issues in healthcare. It was also a great opportunity to exchange cultures and build new friendships. I truly appreciate the warm welcome from the faculty and students.”
• Feng-Chun “Aurelien” Chiu: “Participating in the Nursing Ethics class at UW Bothell was an unforgettable and enriching experience. Engaging in discussions with faculty and students gave me the opportunity to explore different perspectives on ethical decision-making in nursing practice. Presenting in English challenged me to step outside my comfort zone and strengthened both my communication and critical thinking skills. I also appreciated the welcoming environment and the meaningful cultural exchange throughout the visit. This experience has inspired me to continue growing as a compassionate and globally minded nurse. I am sincerely grateful to Dr. Ko and everyone at UW Bothell for their kindness and support.”
• Jia-Ru “Jeyia” Chou: Visiting the Nursing Ethics class and interacting with UW Bothell nursing students was a wonderful experience. Presenting entirely in English was a great challenge for me, but it really built my confidence in public speaking and improved my communication skills. In addition, taking part in discussions with local students allowed us to share different cultural views on healthcare, which truly broadened my perspective. I am very grateful for Dr. Ko’s thoughtful arrangements!
• Chia-Yu “Bella” Wang: “Participating in the Nursing Ethics class at UW Bothell was an unforgettable and enriching experience. It was especially meaningful for me to draw on my previous experience working in a Taiwanese emergency department and share Taiwan’s healthcare system, emergency care, and related ethical issues with the faculty and students. The students were highly engaged, thoughtfully reflected on the topics, and asked many insightful and inspiring questions. Their perspectives encouraged me to reconsider ethical challenges in clinical practice from different cultural and healthcare contexts, and I gained a great deal from our discussions. I sincerely appreciate Dr. Ko’s thoughtful arrangements and the warm welcome and active participation of everyone at UW Bothell.”

Dr. Belza stated, “On behalf of the de Tornyay Center for Healthy Aging, we are thrilled to welcome the visiting nursing students from Taipei. The visiting students have been enthusiastic about their learning experiences both during the week in clinical settings and on the weekend in their cultural immersion on Lopez Island. As we know not all learning occurs in the classroom, we had the opportunity to participate in a 4th of July float on Lopez Island supporting the newly opened public pool. We know from public health that it is critically important we all know how to swim both to prevent drownings and manage chronic conditions. The students’ participation helped the Lopez Island Swim Center float receive the Grand Marshall award!”