ASU nursing student changing lives across the globe

All that stood between Rachel Thompson and completing a crucial piece of a project nearly three years in the making was a little more than 10,000 miles and a few flight connections.

The Arizona State University Edson College of Nursing and Health Innovation Doctor of Nursing Practice, or DNP, student traveled to Malawi, Africa, with ASU's SolarSPELL team to help with the delivery of, and training for, 10 solar-powered digital health libraries to nursing schools there. 

“The students were wonderful. They were so engaged, and seeing how enthusiastic they were to have this resource was exciting. I could tell it would completely change their education,” Thompson said.

It’s a resource she helped curate and develop content for as part of the culminating project for her degree. 

Thompson always knew she wanted to use her nursing education and experience to reach global populations. She graduated from Edson College with a Bachelor of Science in nursing in 2016 and began working in critical care in California. She had a medical mission planned for 2020 but it was canceled due to the pandemic. Later that year, she would get another opportunity to pursue that dream with SolarSPELL.

During her first semester in the DNP program, she took an elective course on equity and social justice in health care taught by Edson College Clinical Associate Professor Heather Ross.

"In our first class, she informed us about a global health education initiative she was a co-director of at ASU called SolarSPELL. I immediately wanted to be involved and started volunteering with SolarSPELL in the fall of 2020. I worked with other students in differing undergraduate and graduate programs to create a nursing midwifery program for the SolarSPELL library intended to be implemented in South Sudan," Thompson said.

Eventually, that led to the opportunity to work on this project in partnership with SolarSPELL, the Malawi Peace Corps Response Advancing Health Professionals Program and Kamuzu University of Health Sciences in Malawi.

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Edson College Clinical Associate Professor Heather Ross (left) was the first person to introduce Rachel Thompson to SolarSPELL. Three years later, the two were on a trip to Malawi together. Photo courtesy Rachel Thompson

A history of collaboration 

SolarSPELL at ASU is a global educational initiative that combines curated digital libraries, solar-power, offline technology, and the training to build information literacy and internet-ready skills in offline environments. The aim is to reach people and places still unconnected, which is about half of the world.

Ross first broached the topic of a nursing and health collaboration with SolarSPELL in 2017. She recognized the potential impact health-focused libraries could have on global health outcomes and quickly established a pathway for Edson College students to get involved.

It is through that connection that DNP students in particular have been working with SolarSPELL for their doctoral projects for a few years. Thompson is at least the ninth student whose culminating project is related to SolarSPELL.

In fact, she collaborated with a pair of DNP students who graduated in 2022 to continue their work to create health-focused training modules for health-care students, educators and practitioners in the developing world.

“Those students conducted evidence-based practice workshops for nursing educators at three schools in Guyana in 2022. Building on their experience, Rachel worked with the SolarSPELL team to deliver an evidence-based practice workshop as a central component of the SolarSPELL health library training in Malawi,” Ross said.

A lesson in global health

A trip to Malawi wasn’t actually part of the initial plan for this project. The group was supposed to travel to Uganda in November 2022 to attend a Peace Corps conference where they would “train the trainers”, in this case, Peace Corps volunteers. But, the conference was canceled due to an Ebola outbreak.

It was a disappointing moment for Thompson. She’d done so much to prepare. On the educational side of things, there was a ton of time and work put in to develop and curate the library's content and prepare in-person presentations. 

On the personal side, she had to secure a visa and required travel vaccines, take time off work and pay for the trip out of pocket.

In the end, the experience turned out to be one big lesson in how global health works.

“I learned that you must have a lot of patience when working in the global health space. That was something Dr. Ross tried to teach me early on when our first trip got canceled because I’m very type A so I want to know every detail. I had to trust that when it comes to these things, however, it’s meant to be is how it will work out, and usually, it works out well. That’s also a life lesson I’ve learned personally as well through all of this,” Thompson said.

Her hopes of delivering the libraries in person were renewed when the team pivoted and decided that Kamuzu University of Health Sciences in Malawi would be an excellent location to implement those libraries.

On the ground in Malawi

So, it was with both great preparation and anticipation that she embarked on a 32-hour journey in January to make the life-changing trip to Malawi.

"I spent a lot of time preparing for my presentation in Malawi. As a guest in their country, I wanted to ensure that I was offering this new knowledge in a way that was not insulting their current practices,” she said.

The content Thompson worked on was customized to align with the cultural practices and norms of the region with consideration given to the resources available.

Students have internet access on the two Kamuzu University of Health Sciences campuses the ASU group visited — in Blantyre and Lilongwe. However, for some of their clinical rotations, where they get hands-on experience with patients, they travel for weeks at a time to remote villages that do not have internet access.

“The current setup is that they carry library books, most of which are bulky and assigned to one individual, usually a group leader,” said Patrick Mapulanga, senior assistant librarian at Kamuzu University of Health Sciences campus in Lilongwe.

In total, the ASU group spent a little more than a week on the ground in Malawi traveling to Blantyre and Lilongwe for campus visits. During those visits, they met with administrators, faculty, students and librarians. 

This was when Thompson was able to bring her work to life facilitating workshops introducing the modules, and the types of content available and describing their usability for each stakeholder.

“Overall, they seemed eager about the concept of evidence-based practice. Currently, the university incorporates research courses in their curriculum, so while they weren’t familiar with this exact process, it was apparent they already implement many stages of the process, just not in this systematic approach that makes it easy to follow or easy to teach,” she said.

Almost immediately, the workshop attendees identified the ripple effect this new resource would have across their communities.

“Incorporating evidence-based practice modules and information into the curriculum can help students become more knowledgeable, skilled and confident health-care providers. This can lead to improved patient outcomes and better quality of care,” Mapulanga said.

Thompson also created a PowerPoint presentation for faculty to download as a lesson plan and teach. That was something the faculty were especially interested in, as it was ready to go and would be easy to incorporate into their research course.

“The evidence-based practice materials and information delivered by Rachel was very important, as it uplifted staff lecturers on how to care for patients qualitatively. This was a super-model of information generation for patient care,” said Noel Mbirimtengerenji, a senior lecturer at the University of Health Sciences campus in Lilongwe.

Mbirimtengerenji and Mapulanga both attended the workshops and said they were looking forward to all the different ways in which they could use the SolarSPELL health libraries both on campus and in the field.

Next steps

ASU Associate Professor Laura Hosman said all three partners agreed on a plan to take this pilot project through the end of 2023, “with activities designed to demonstrate the use, impact and effectiveness of the SolarSPELL health libraries.”

For her part, Thompson is working on publishing a manuscript about her experience and the results she collected. She also plans to follow up with a survey and would like to find a way to make this a legacy DNP project so future students can continue to expand and develop it.

And even though she will graduate this May with an advanced nursing practice (family nurse practitioner), DNP degree, she’s not ready to leave this all behind and plans to continue to work with SolarSPELL as much as she can even after graduation.

"SolarSPELL is an incredible organization, and this experience was life-changing in many ways for me. I am so grateful to have had the opportunity to work alongside the team and travel to witness the impact SolarSPELL is making halfway around the world. I'm truly inspired by the students and faculty at KUHeS and hope to continue to be part of this incredible education initiative."