Nurse Education Today 46 (2016) 139145

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Nurse Education Today

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The process of internationalization of the nursing and midwifery

curriculum: A qualitative study
Khadizah H. Abdul-Mumin
Universiti Brunei Darussalam, PAPRSB Institute of Health Sciences, Gadong BE1410, Brunei Darussalam

a r t i c l e i n f o a b s t r a c t

Article history: Background: There is an abundance of literature on internationalization of curricula. However, research on
Received 19 September 2015 how a curriculum is internationalized to accommodate non-mobile students studying in their home countries
Received in revised form 21 August 2016 is limited.
Accepted 7 September 2016 Objective: To describe the process undertaken by curriculum developers in internationalizing the Brunei nursing
Available online xxxx
and midwifery curriculum through curriculum design.
Design: A descriptive qualitative research design.
Keywords:
International
Setting: A nursing and midwifery higher education institution in Brunei.
Education Participants: Seventeen nurse/midwife academics.
Nursing Methods: Semi-structured interviews were conducted with 17 curriculum developers. Data were analyzed using
Midwifery thematic analysis.
Curriculum Results: Four themes emerged: expectations of an internationalized curriculum; formation of a committee;
Brunei benchmarking and setting standards; and designing the curriculum for internationalization.
Conclusions: This study has implications for the development of an internationally-oriented curriculum that takes
into account the cultural context of a specic country. The ndings highlight the need to involve students in
curriculum design, a practice that is not common in Brunei.
2016 Elsevier Ltd. All rights reserved.

1. Introduction Darussalam, 2013), which is equivalent to a B + or 65% in the UK.

Internationalization of higher education demands that higher educa-
tion institutions provide education informed by global events, ensure
programs have international relevance, and teach skills that are applica-
ble in global markets (Luxon and Peelo, 2009). Brunei is one of many
countries that aspires to provide nursing and midwifery education
that is recognized and comparable internationally (Abdul-Mumin,
2016; Mumin, 2015a; Mumin, 2015b). As part of internationalization ef-
forts, undergraduate students enrolled in Brunei's GenNEXT Degree
Program, including those studying nursing and midwifery, can now par-
ticipate in a semester to a 1-year (two semesters) study abroad program
(Mundia, 2012). Eligible students can choose from many countries, in-
cluding the UK, Germany, the United States, Japan, and Malaysia. How-
ever, these opportunities are only available to high-achieving students
with grade point averages of 4.0 and above (Universiti Brunei
Acknowledgements and Funding
This research project is unfunded. However, the researcher received a salary from the
Government of Brunei Darussalam via the Ministry of Education, who also granted leave
and paid for research support through doctoral training in England. The author would
like to thank all participants involved in this study, as well as Professor Judith Lathlean
(Professor of Health Research, University of Southampton, United Kingdom) for her guid-
ance and tireless support.
E-mail address: khadizah.mumin@ubd.edu.bn.
Most students scoring below this average are deemed ineligible to
study abroad, and generally cannot access international experiences un-
less they are willing and able to self-nance. Therefore, it is important to
design a curriculum that addresses this inequity in international experi-
ence by ensuring that all graduates attain the same high level of
knowledge.
This paper presents ndings from a study on the internationalization
of the nursing and midwifery curriculum in Brunei; specically, curric-
ulum design whereby international perspectives are integrated into
the local curriculum. The experiences of curriculum developers
concerning the process of internationalizing the curriculum through
curriculum design are discussed. Because this topic has not previously
been studied in Brunei, international literature was explored to examine
the current knowledgebase.
1.1. Operational Denitions
For the purpose of this study, the singular term nursing and mid-
wifery curriculum refers to nursing and midwifery curricula at differ-
ent levels (e.g., diploma, advanced diploma, degree) for various
specializations (e.g., critical care nursing, operation theater nursing, pe-
diatric nursing, community health nursing). Internationalization
means the process of integrating international perspectives into a local

http://dx.doi.org/10.1016/j.nedt.2016.09.003
0260-6917/ 2016 Elsevier Ltd. All rights reserved.
140 K.H. Abdul-Mumin / Nurse Education Today 46 (2016) 139145
curriculum to develop an internationalized/international curriculum.
Internationalized or international curriculum denotes a curriculum
with international perspectives or content designed for non-mobile stu-
dents (domestic and foreign) who cannot obtain internationalization
experiences abroad. International perspectives means knowledge,
ideas, models, principles, theories, or concepts that encompass intercul-
tural, multicultural, and international aspects.
1.2. Internationalization of the Curriculum
The process of internationalizing higher education is complex,
encompassing various initiatives, strategies, and activities. There are
two common ways of internationalizing higher education: (1) at
home, by infusing international content into the curriculum for local
students; and (2) abroad, by sending students to attend educational
programs in other countries (Knight, 2004). Internationalization of the
curriculum commonly refers to structuring courses, programs, and
qualications to focus on comparative and international themes that
emphasize the development of international and/or intercultural global
competencies (Egron-Polak and Hudson, 2010; Knight, 2004). Students
are expected to display knowledge of, skills relevant to, and open atti-
tudes toward, diverse cultures (Olsson, 2010). In addition, an
internationalized curriculum should enable students to work in any
global context (Luxon and Peelo, 2009).
1.3. Integration of International Perspectives into the Local Curriculum
Existing studies emphasize internationalization via experience
in other countries. However, research on how a curriculum is
internationalized to accommodate non-mobile students studying in
their home country is limited. An abundance of literature has focused
on short- and long-term study abroad programs or internationaliza-
tion across borders, in which students engage in theoretical and/or
clinical experiences in another country (Olsson, 2010). Literature is
also available on topics such as international standards and collabo-
rations in developing curricula (Uys and Middleton, 2011; Wright
et al., 2005); perceptions about internationalization of the curricu-
lum (Ruddock and Turner, 2007); uniformity in internationalizing
curricula (Lahtinen et al., 2014); and inuencing factors, rationales,
and implications for internationalizing curricula (Egron-Polak and
Hudson, 2010; Kent-Wilkinson et al., 2015).
The literature review identied two published studies related to
nursing and midwifery focused on integration of perspectives from
international curricula into local curricula (Jayasekara and Schultz,
2006; Xu et al., 2002). Xu et al. (2002) conducted a study in China on
nurse academics' perspectives of the relevance of integrating 21 key
concepts extracted from The Essentials of Baccalaureate Education for
Professional Nursing Practice, produced by the American Association
of Colleges of Nursing (1998) for use in China. Participants in that
study acknowledged the relevance of that document to nursing in the
United States, and recognized that it provided a framework for develop-
ing, dening, and revising a baccalaureate nursing curriculum, but sug-
gested it needed to be adapted to the Chinese culture and context.
Jayasekara and Schultz (2006) conducted a comprehensive system-
atic review to appraise and synthesize the best available evidence on the
feasibility and appropriateness of introducing nursing curricula from
developed countries into developing countries. They posited that most
developing countries borrow concepts and curricula directly from de-
veloped countries, mainly owing to the global nursing inuence from
those countries. The authors suggested the direct transplantation of a
curriculum model from one culture to another was inappropriate
without prior assessment of cultural relevancy. They argued that a col-
laborative approach encompassing international, regional, and local ex-
perience was more effective in ensuring adaptability of curricula across
countries that are culturally and socially different (Jayasekara and
Schultz, 2006).
2. Methods
2.1. Research Design
A qualitative descriptive design was used to explore and describe
curriculum developers' experiences of the process of internationalizing
the nursing and midwifery curriculum in Brunei through curriculum de-
sign. The design was appropriate because the study aimed to gather data
that describe an event or process (Lincoln et al., 2011). This study was
also guided by the constructivist-interpretive paradigm that highlights
the construction of knowledge as a result of the collective interpretation
processes of the researcher and the researched (Lincoln et al., 2011).
2.2. Participants and Setting
This study was conducted in a nursing and midwifery education pro-
vider in Brunei. There were initially three nursing and midwifery educa-
tion providers in Brunei that were later merged into one institution. The
present study commenced before and continued after this merger.
To begin with, forty nurse/midwife academics working as curricu-
lum developers (henceforth curriculum developers or participants)
in the study institution were individually approached to ascertain their
interest in the study. Participants were selected using a purposive sam-
pling strategy (Lacey, 2015) guided by comprehensive inclusion and ex-
clusion criteria (Table 1). There is no clear guidance available on
determining sample adequacy in qualitative research. However, the
main aim of qualitative research is to explore and increase understand-
ing of a phenomenon by gathering high-quality data (Seale et al., 2007),
rather than establishing a large sample to allow generalization of the
ndings to a wider population. Therefore, data saturation (Morse,
2000) was used to determine sample size. Data saturation was achieved
after interviewing 15 curriculum developers, and conrmed by
interviewing a further two participants, giving a total of 17 participants
included in this study.
2.3. Ethical Considerations
When the study began, there was no research ethics committee in
the institution where the study was performed (which is under the aus-
pices of the Brunei Ministry of Education). All research undertaken
within the Ministry of Education in Brunei must be approved by the
Ofce of the Deputy Permanent Secretary of the Ministry of Education.
A formal letter was sent to this Ofce via the institution where the
study was to be conducted, and the study was approved by that Ofce.
Potential participants were given invitation letters and study infor-
mation sheets to ensure they were fully informed about the study. Par-
ticipation was voluntary, and participants had the right to withdraw
from the study at any time. The researcher also invited potential partic-
ipants to ask questions to clarify the details of the study, facilitating an
informed decision to participate (Flory and Emanuel, 2004). Written
consent was obtained from all individual participants. In this paper,
pseudonyms are used to protect participants' anonymity (e.g., CD1
[curriculum developer 1], CD2, and so on).
Table 1
Inclusion/exclusion criteria for selection of participants.
Parameter Inclusion criteria Exclusion criteria
Job appointment Nurse/midwife Clinical instructors
educators Retirees
Work experience and experience 1 year or more Less than 1 year
in Brunei's curriculum
development
 K.H. Abdul-Mumin / Nurse Education Today 46 (2016) 139145
2.4. Data Collection
Semi-structured, face-to-face, in-depth individual interviews were
conducted by the researcher in the participant's preferred language
(the national language of Brunei, Malay, and/or English) to facilitate
open and comfortable conversation. An interview guide (Table 2) was
designed that focused on the topics being explored while allowing ex-
ibility. Trial interviews were conducted with four participants. The in-
terview guide required only minor modications, and these trial
interviews were later included in the main study. Participants were en-
couraged to ask questions and were informed that: (i) they did not have
to answer any questions that they preferred not to; (ii) there were no
right or wrong answers; (iii) the researcher was only interested in
their views; and (iv) they could terminate the interview at any time.
The interviews were conducted at a time and place chosen by the partic-
ipants, usually after working hours at their homes or ofces, and were
free from environmental distractions. The interviews were audio re-
corded with the participants' consent and lasted 4590 min. In addition,
notes were recorded in a diary before and after the interviews to aid the
process of reexivity (Gilgun, 2010).
2.5. Data Analysis
Interviews were transcribed verbatim and fully translated into En-
glish. Next, each transcript was read and reread, followed by line-by-
line coding, which began with an initial coding process (Charmaz,
2014), also known as open coding (Corbin and Strauss, 2015). Coding
then became more focused, and the most frequent initial codes were
used to sort, synthesize, integrate, and organize large amounts of data
leading to the formation of themes (Charmaz, 2014). Next, the constant
comparative method (Maykut and Morehouse, 2003) was used. Similar
and overlapping codes were constantly examined and rened until
all data were accounted for and no further coding was necessary
(Charmaz, 2014). At this point, the researcher determined data satura-
tion to have been achieved. Data saturation is reached when no new cat-
egories or themes emerge and the depth and variation of major
categories or themes is evident (Corbin and Strauss, 2015). Microsoft
Word and Excel programs were used for the management of qualitative
data analysis.
2.6. Rigor
All participants had sufcient mastery of both English and Malay.
The researcher requested that participants' commented on and con-
rmed the accuracy of their interview translation, focusing on sentence
construction that produced meaning-based translations rather than
Table 2
Interview guide.
Topics Questions
Role in curriculum development Please describe your role in terms
of curriculum development
Factors and issues considered in What is considered?
curriculum development When?
How?
Why?
Western or international Any evidence of inclusion?
perspectives integrated in What was included?
the curriculum Why was it included?
How was it included?
Views on the internationalization What are your views?
of the nursing and midwifery What is your general understanding
curriculum in Brunei of internationalization?
Why? (Why develop an internationalized
curriculum?)
Relevance to Brunei
141
word-for-word translations (Jones and Kay, 1992; Squires, 2008). No
changes were requested. Data analyses were conducted independently
by the researcher, and themes were checked repeatedly for consistency
of interpretation (Table 3). Relevant quotations from participant inter-
views are presented in the Results. The above details provide a decision
or audit trail for this study (Lincoln et al., 2011).
3. Results
3.1. Participant Prole
Study participants were seventeen curriculum developers (nurse/
midwife academics), three of whom were male (Table 4). They aged
2655 years, had 240 years of work experience, and their highest qual-
ications were bachelor or master degrees. For condentiality reasons,
participants' gender and precise information concerning age, years of
experience, and the name of the specic curriculum they designed are
not reported.
3.2. Themes
The process of internationalizing the Brunei nursing and midwifery
curriculum through curriculum design reected an internationalization
process that involved integrating international perspectives into the
curriculum. There are four main themes identied that reected partic-
ipants' descriptions of this process. In the rst theme, the curriculum
developers' expectations of internationalization of the curriculum
are described. In the other three themes, the steps conducted to
internationalize the curriculum are represented. The rst step in
internationalizing the curriculum is described in the second theme
formation of a committee to develop the curriculum. The second step
is depicted in the third theme benchmarking and setting standards,
and the third step is illustrated in the fourth theme designing the cur-
riculum for internationalization.
3.3. Expectations of Internationalizing the Brunei Curriculum
There are more than half of the participants whom emphasized that
curriculum internationalization fostered international collaboration,
provided opportunities for selected students to go abroad for interna-
tional experiences, and ensured no student is deprived of the chance
for similar international experiences.
Internationalization is important [for] collaboration or partnership
with other universities, for examplethe discovery year, a one-
year study abroad program in the BHSc (Bachelor of Health Sci-
ences) course for the best studentsWe also want our students
who are deprived of opportunities to go abroad to equally have ex-
posure to international experiences. (CD10)
The majority of participants made an association with marketabili-
ty when explaining the internationalization of the curriculum. They de-
ned marketability as the ability to attract paying international
applicants to study in Brunei, as well as the viability of Brunei students
and graduates being accepted for further education and work globally.
This aligned with one of the university's mission statements, which is
to become one of the most renowned universities in the world. As one
participant said:
We want our programs to be marketable. To sell our programs, the
curriculum needs to be lucrative for people from outside BruneiIt
is the mission of our University to become one of the most chosen
universities worldwideOur students and graduates must be able
to pursue study and work, not only in Brunei, but also abroad
The curriculum should prepare them with skills for studying and
working globally (CD2)
142 K.H. Abdul-Mumin / Nurse Education Today 46 (2016) 139145

Table 3
The coding process.

Focused coding Preliminary themes Final themes

Perceptions of internationalization of the curriculum Expectations of internationalizing Expectations of internationalizing curriculum

Forming a committee to develop the curriculum Committee formation Committee formation
Searching for guidelines for benchmarking and setting standards Benchmarking Benchmarking
Value of benchmarking to set standards Benchmarking
Setting standards benchmarking Benchmarking
Evaluating and identifying guidelines for developing curriculum Identifying guidelines for benchmarking
Features and structure of the curriculum Designing the curriculum Designing curriculum for internationalization
The relevance of curriculum content Determining the scope of internationalization
Marrying or blending with the local context Adapting international perspectives in the curriculum
Identication, adaptation, application and incorporation Internationalizing the curriculum

3.4. Committee Formation 3.5. Benchmarking and Setting Standards

All participants highlighted the importance of forming a develop-
ment committee, which was indicative of a collaborative approach
and sense of team responsibility toward curriculum development.
In order to develop the curriculum, we have to form a committee
that works together, and meets regularly to design the whole curric-
ulum until the curriculum is completely developed. (CD16)
These committees commonly comprised nursing and midwifery ac-
ademics, as well as stakeholder representatives from the Brunei Minis-
try of Health (MoH). Involvement of MoH representatives ensured the
provision of clinical learning experiences and environments that pro-
duce graduates best suited to work in Brunei. The selection of commit-
tee members highlighted the curriculum developers' expectations that
the curriculum should reect subject matter expertise and information
on current practices in Brunei.
They are local Bruneians and also expatriates from the US, UK,
Canada, and Oz [Australia], all specialized in their area, and stake-
holders from the MoH. With the stakeholders' viewpoints, we actu-
ally identify the essential content, look at what happens in Brunei
and abroad, and what we are going to include in our curriculum.
(CD3)
All participants explained that the committee searched and identi-
ed available guidelines for benchmarking, setting standards, and de-
termining the contents of Brunei's nursing and midwifery curriculum.
They discussed the difculty of developing a curriculum in the absence
of guidelines.
Developing a curriculum is not easy without guidelines. It is like
walking blindfolded. We need guidelines for setting the standards
of the curriculum as a whole. (CD1)
All participants recognized the need for, and importance of, guide-
lines for developing a curriculum to a standard comparable to those of
other countries, and highlighted the value of benchmarking to set stan-
dards for the curriculum.
The most important thing is benchmarkingWe have to benchmark
or follow standards or a framework that is already established inter-
nationally. (CD4)
The lack of guidelines in Brunei on internationalizing the curriculum
encouraged the committee to search for any available documents, such
as curricula, student handbooks, or similar documents from a variety of
sources in many different countries, including universities, professional
bodies, and international organizations.

We started off by collecting documents that we obtained from our

previous study abroad, those nurses and midwives in the MoH that
have studied abroad, and also those that we can retrieve from the in-
Table 4 ternetmainly curriculum documents, clinical placement guide-
Participant prole.
Degree: Degree in nursing or midwifery or other.
lines, and course handbooks from universities in the UK, USA,
Master: Master degree in nursing or midwifery or other. Australia, Canada, and many other countries. (CD17)
CD: Curriculum developer.

Curriculum Age range Years of Highest

Documents from the UK Nursing and Midwifery Council and UK uni-
developers (years) experience qualication versities were used as primary guidelines for setting curriculum stan-
dards. Participants made this decision based on familiarity with UK
CD1 3645 1120 Master
CD2 3645 1120 Degree nursing and midwifery, and their perceptions of professional practice
CD3 3645 0110 Degree in the UK as the most established, renowned, and reputable in the
CD4 4655 3140 Degree world. They also explained that the curriculum content was further
CD5 4655 3140 Degree benchmarked against documents from various countries and interna-
CD6 3645 1120 Master
CD7 4655 3140 Master
tional organizations, such as the International Confederation of
CD8 4655 3140 Master Midwives, the International Council for Nurses, and the World Health
CD9 2635 0110 Master Organization, to ensure that the Brunei curriculum met minimum inter-
CD10 4655 3140 Master national standards.
CD11 4655 3140 Degree
CD12 4655 3140 Master
CD13 3645 1120 Master We benchmarked our curriculum with the UK universities, and NMC
CD14 4655 2130 Master [Nursing and Midwifery Council] UK standards...We developed the
CD15 4655 3140 Master contents of the curriculumexplored and examined what happens
CD16 2635 0110 Master in the many countries outside of Brunei, and requirements of the
CD17 3645 1120 Master
international bodies, the ICM [International Confederation of
 K.H. Abdul-Mumin / Nurse Education Today 46 (2016) 139145
Midwives], ICN [International Council for Nurses], WHO [World
Health Organization]in order to make sure that our curriculum is
based on current research ndings and evidence and is up to date.
(CD13)
3.6. Designing the Curriculum for Internationalization
The process of designing the curriculum aimed to internationalize
the curriculum. This process was described as dynamic with inter-
changeable, interrelated, and interwoven steps. All participants report-
ed the process involved discussion of how the curriculum would be
developed in consideration of, and comparison with, documents identi-
ed as guidelines for benchmarking. These documents, together with
the curriculum developers' background knowledge and previous inter-
national experience, were discussed, reected on, analyzed, and evalu-
ated by the committee.
Collective decision making was used to determine how these docu-
ments could be best used to inform development of the Brunei
curriculum.
We shared our experiences as students when we did our degrees in
different universities in the UK, Australia, and CanadaWe looked at
our curricula, handbooks, assessment packages, and all documents
we collected, discussed how we are going to structure our [Brunei]
curriculum, the topics to be taught, how to teach, how we felt about
the topics, and the teaching and assessing methods that we are going
to use. (CD15)
Participants explained that discussions facilitated identication of
international perspectives considered relevant the Brunei curriculum,
and highlighted the importance of preserving the Brunei context. Partic-
ipants used the terms local values and Brunei context interchange-
ably to encompass ideas related to the social and cultural attributes of
the diverse peoples of Brunei. Participants repeatedly noted three es-
sential components of the Brunei context. The rst was the Malay peo-
ple and Malay culture, which is the major cultural group in Brunei. The
second was Islam, the ofcial and dominant religion of Brunei. The third
component was the political climate of Brunei, which is the Malay Is-
lamic Monarchy (MIB). The religion and culture of the people of
Brunei, along with the political climate, have important implications
for designing and internationalizing the Brunei nursing and midwifery
curriculum. These culturally critical components shaped the design
and internationalization of the curriculum, which was therefore inu-
enced by the Islamic faith and the Brunei Malay culture. For example,
the international perspectives integrated in the curriculum must not
conict with the religion, culture, and politics of Brunei.
We put international perspectives into our curriculum, but also
protected our local values. There are many religions practiced in
BruneiOur ofcial religion is Islam, our country's philosophy is
the MIBseven different Malay groups in Brunei, as well as the
many different expatriates in Brunei. The international perspectives
that we include and adapt in our [Brunei] curriculum must not be in
conict with the culture, religion, and political context of Brunei.
(CD5)
All participants noted that international perspectives integrated in
the Brunei curriculum must be practical, acceptable, and relevant to
the Brunei context.
With regard to [trends in a specialty care area], we have to really
make a decisionIs it time now? or, shall we wait another ve
years in order to put the knowledge in the curriculum? If we put
this in, where would the students acquire the experiences? Is this
relevant to Brunei and the students? We want to make it more
143
contextual to Brunei by examining the suitability and practicability
of the knowledge to culture, religion, and social context of Brunei.
(CD6)
Once relevant international perspectives were identied, partici-
pants indicated that they had to modify some of these to adapt them
to the Brunei context. This ensured the curriculum was not simply cop-
ied from documents from other countries, and thus lacking in relevance
to Brunei's situation.
We used the existing documents, as well as modifying the content
based on our previous experiences in our courses, and the various
experiences from the UK, Australia, Canada, Africa, and the US were
taken into account and compared with the different situation in
Brunei. We wanted our curriculum to be relevant to Brunei. (CD11)
The majority of participants highlighted that to ensure the interna-
tional perspectives were relevant to Brunei, critical thinking was needed
to understand their relationship and signicance to Brunei.
The practice of leadership of our Prophet Muhammad such as that of
the Muzakarah [group meeting and brainstorming] can be associ-
ated with the principles of leadership such as laissez-faire, and with
the MIB philosophy. The association [can be made] between what
was in the Qur'an on doing good and doing no harm and teaching
the ethical principles of benecence. (CD12)
4. Discussion
This study indicates that internationalization of the Brunei nursing
and midwifery curriculum through integration of international perspec-
tives was perceived as important by curriculum developers. They
stressed the need to offer all students equal opportunities for exposure
to international experiences through the internationalized curriculum,
and eliminate the bias of only focusing on sending high-achieving stu-
dents to join study abroad programs.
This study highlighted the benets of using a committee structure to
facilitate collective decision making throughout the curriculum devel-
opment process. The committee ensured that the curriculum was devel-
oped through teamwork, and created a sense of shared ownership of the
curriculum. This resonates with existing literature that indicates mutual
agreement and collective decision making in curriculum design are
powerful if undertaken in a team setting (Iwasiw et al., 2009; Keating,
2010).
In this study, the importance of involving stakeholders (i.e., MoH
representatives) as key providers of information on current and rele-
vant practical curriculum components is claried. This is consistent
with previous literature on collaborative curriculum development in-
volving colleagues who can serve as experts, give practical input, and
suggest appropriate practice experiences (Keogh et al., 2010; Speers
and Lathlean, 2015).
It is acknowledged in the literature that students are credible stake-
holders who can also be involved in curriculum development. Their role
in sharing their learning experiences and perspectives, combined with
their needs and aspirations, makes invaluable contributions to curricu-
lum development (Anderson et al., 2015; Edwards et al., 2015). Howev-
er, this recommendation was not supported by the ndings of this
study, because students were not involved in the curriculum develop-
ment committees in Brunei. Therefore, it is recommended that student
involvement be considered in future curriculum development.
Benchmarking was identied as integral to the process of
internationalizing the curriculum. Curriculum developers searched for
guidelines on internationalizing curricula, but were unable to nd any
in Brunei. This led them to search beyond Brunei, and they dened
guidelines as documents originating from any country that contained
144 K.H. Abdul-Mumin / Nurse Education Today 46 (2016) 139145
potential benchmarking standards against which Brunei's curriculum
could be compared. The practice of international benchmarking in-
volves comparing programs or courses offered by educational institu-
tions in one country with those offered by international institutions, to
assess the strengths and weaknesses of both (Mok and Chan, 2008;
Hall, 2014). Benchmarking can be practiced by educational institutions
globally in designing curricula in general, as well as in internationalizing
a curriculum.
In view of the fact that the Nursing Board of Brunei does not current-
ly regulate nursing and midwifery education in Brunei, benchmarking
can be considered the best practice in developing and internationalizing
the nursing and midwifery curriculum. This administrative vacuum sug-
gests that the Nursing Board of Brunei should add the production of
guidelines and monitoring, standardizing, and regulating nursing and
midwifery education to its functions in future.
The ndings of this study support existing understanding that inter-
nationalization is valued equally in the agenda of higher education
institutions in both Western and Eastern contexts. The process of
internationalizing the curriculum is identied as continuous and dy-
namic, rather than as a linear process. In the context examined here,
the processes were interlinked with and involved reection, discussion,
and critical analysis that challenged the curriculum developers in
selecting, adapting, and integrating the most relevant international
perspectives. In this study, a cultural approach to internationalizing a
nursing and midwifery curriculum are evident whereby curriculum de-
velopers opted to integrate only those international perspectives that
were perceived to be culturally acceptable and useful in the Bruneian
context. Existing literature conrms the importance of this practice,
suggesting consideration of the relevance of Western ideology and con-
cepts imported into a non-Western context (Jayasekara and Schultz,
2006; Xu et al., 2002). Collaboration with curriculum developers from
universities outside Brunei (Western and non-Western) may be a way
forward in determining how international perspectives may be best
adapted and integrated into the Brunei curriculum.
In conclusion, in this study, an internationalization effort that used
benchmarking as an integral process with consideration of the social, re-
ligious, cultural, and political contexts of different countries are viewed
as fundamental by curriculum developers. More importantly, this study
is novel to Brunei and adds to the cross-cultural education research and
literature, specically nursing and midwifery education, at local and in-
ternational levels.
4.1. Limitations
Future studies that explore international students', graduates', and
expatriate curriculum developers' experiences of curriculum interna-
tionalization in Brunei are recommended. Inclusion of patients or clients
receiving care from students educated in the internationalized curricu-
lum may also help in determining whether the curriculum content ap-
propriately meets the expectations of service users in a local context.
4.2. Recommendations
This study has implications for the development of internationally
oriented curricula that consider the relevant cultural context. The nd-
ings highlight a need to involve students in curriculum design, a practice
that is not common in Brunei. Further interviews were conducted with
curriculum developers on the in-depth process of a cultural approach in
internationalizing the curriculum; and student and graduate experi-
ences of the internationalized curriculum. The ndings from these inter-
views will be presented separately.
5. Conclusion
The importance of integrating international perspectives into
the Brunei nursing and midwifery curriculum as a means of
internationalization at home is emphasized in this study. This will
benet non-mobile students in their home countries who may have
fewer opportunities for international experiences, as well as high-
achieving students who have more opportunities to study abroad. An
internationalized curriculum enhances nurses' and midwives' readiness
for the workplace in various international settings.
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