Education and Human Sciences, College of (CEHS)


First Advisor

Gina Matkin

Date of this Version



A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Doctor of Philosophy, Major: Human Sciences (Leadership Studies), Under the Supervision of Professor Gina Matkin. Lincoln, Nebraska: August 2017

Copyright (c) 2017 Julie M. Shasteen


This phenomenological study describes the experiences of primary care physicians trained in the United States who participated in an international clinical immersion rotation during medical school or residency. Five central themes emerge relating to their experience: (a) Participants chose the international rotation for developmental purposes. (b) The lifestyle in their destination country was different than in the U.S., and this had an impact on participants. (c) There were positive outcomes for participants and their future practice. (d) Harmful external forces (at the rotation site) shortened patients’ lifespans and had a negative impact on their quality of life. And, (e) participants wonder whether they have chosen the right profession.

The process of participating in the immersion experience helped participants grow, think, and feel in new ways, both professionally and personally. They developed observational skills by living in the same environment as their patients. They learned resourcefulness as they solved practical problems with no one to support them. They became more confident through their daily work and by being considered “the doctor.” They learned to adapt to the ways of people and cultures that “slow down” and live at a different pace compared to people in the U.S.

One particularly significant observation is that they described changes and awareness consistent with growth in cultural competence, even though this was not their primary intention. The essence of the immersion experience is a constellation of developmental growth areas for primary care physicians who participated, but evidence of possible cultural competence development is at the forefront.

Adviser: Gina S. Matkin