Fulbright-Nehru: A Transformational Experience

  • Dr. Shelby Garner (left) and Leena S., director of the Institute of Nursing at Bangalore Baptist Hospital, prepare to host a regional conference to share simulation strategies with nurses around India. Photograph courtesy Dr. Shelby Garner
  • Dr. Shelby Garner (center) teaches Bangalore Baptist Hospital nursing students in the simulation lab. Photograph courtesy Dr. Shelby Garner


The Fulbright-Nehru program is a catalyst for transforming personal and professional relationships. 

My 2016-18 Fulbright-Nehru Research Flex grant changed and enriched my life, both professionally and personally.  The time in India and the resources afforded to me through the Fulbright-Nehru provided an opportunity for transformed personal and professional relationships and was a catalyst for new relationships and partnerships.  


I am an Associate Professor of Nursing at The Baylor University Louise Herrington School of Nursing in Dallas, Texas where I teach Research in the undergraduate program and Global Healthcare, Leadership, and Statistics courses in the graduate program.  My research trajectory for the last 10 years has involved building nurse and health system capacity globally through the adaptation, design and testing of innovative technologies to transform health education and improve patient care.  


The purpose of my Fulbright-Nehru award was to collaborate with nursing colleagues at Bangalore Baptist Hospital (BBH) in Bengaluru, India to evaluate the impact of healthcare simulation use in Bachelor of Science in Nursing and General Nurse Midwife programs in Bengaluru, India.  Simulation involves the use of human patient robotics to provide opportunities for nurses and healthcare providers to test their clinical decision-making and critical thinking skills in a safe environment, and is an evidence-based teaching and learning method to improve patient care. 


Prior to the Fulbright-Nehru award, Baylor University and Bangalore Baptist Hospital were awarded a grant by the United States Agency for International Development (USAID) to build a Simulation Education and Research Centre for Nursing Excellence at BBH.  Together with my colleagues at BBH, we integrated simulation into nursing curricula using this new simulation lab, which showed to have a positive impact on nursing student competency and nursing teacher self-efficacy.   


Additionally, the project fueled research capacity among my nursing and health provider colleagues in India who co-authored several related articles in scholarly scientific journals and presentations at international nursing conferences to disseminate our results as referenced in the list below.  We were especially excited when our work was recognized at the 29th International Nursing Research Congress, Sigma Theta Tau International in Melbourne, Australia as the winner for the 2018 Excellence in Educational Research Award, awarded by the Sigma Theta Tau International/Chamberlain College of Nursing Center for Excellence in Nursing Education.  


While my Fulbright-Nehru experience focused on researching and integrating best practices in healthcare simulation into the nursing program at BBH, a variety of new projects stemmed from my time in India. I was invited to attend a symposium on advancing digital infrastructure in India to improve vulnerable population health outcomes.  During this symposium, I learned about the unique healthcare access challenges faced by people living in low-income urban communities and rural villages in India and was able to take part in brainstorming ideas to combat these challenges.  We discussed how simulation and virtual reality simulation could be used as a wide-reaching digital teaching tool in these hard to access populations.  


Ultimately, these discussions turned into a multidisciplinary international partnership between Baylor University, (BBH), an E-Health Enablers, digital tech company in India, and Green Gold Animation, an animation company.  Together we were awarded funding from Baylor University and the United States India Education Foundation (USIEF) to do more simulation training and to build fun, entertaining, 3D animated mobile health applications culturally tailored for an Indian population to improve hypertension and diabetes health literacy among vulnerable populations.  


Our apps were tested among more than 600 people living in low-income urban communities and rural villages and proved to improve hypertension and diabetes health literacy rates among participants. Additionally, we recently tested the apps among a subpopulation of Indian migrants in Hong Kong to determine the global application and sustainability of the apps, and again the apps had a statistically significant impact on improving hypertension and diabetes health literacy among users.


While the Fulbright-Nehru has greatly contributed to my professional growth, the most profound impact in my life has been through personal growth and transformation. I have made lifelong friends with people from all walks of life in India and I believe these friendships have expanded my understanding for all people.  This experience made me a more culturally humble person.  Cultural humility encompasses being open to others and having an understanding that one can never be fully competent in another’s culture. Instead we should take a humble approach as learners when it comes to understanding each other.


Before my Fulbright-Nehru experience, I prided myself as being an open person with few biases. However extended time in India forced me to come face to face with my own biased opinions that likely interfered with my communications and relationships.  I learned time and again that we are all individuals and that I shouldn’t apply things I learned about individuals to an entire society or culture.  I began to understand and appreciate the rationale for many cultural practices.  


As I gave greater respect to and adapted to the culture, I was given more credibility by my friends and colleagues who also listened and respected me when I had a differing opinion on a subject. I learned the power of mutual respect and gained a richer knowledge of the concept of mutual understanding. I believe it has made me a better person, a better nurse and a better teacher and will forever be grateful for the experience.


Dr. Shelby Garner is an associate professor at Baylor University Louise Herrington School of Nursing.

Related Articles Disseminating Results of Nursing and Health System Capacity Building Strategies in India

Garner, S. L., Killingsworth, E., Bradshaw, M., Raj, L., Johnson, S. R., Abijah, S. P., Parimala, S., & Victor, S. (2018).  The impact of simulation education on self-efficacy towards teaching for nurse educators. International Nursing Review 65(4), 586-595.

Garner, S.L., Killingsworth, E., Bradshaw, M., Raj, L. (2018).  The effectiveness of simulation education on improving self-efficacy towards teaching among nurse educators in India.  29th International Nursing Research Congress, Sigma Theta Tau International, Melbourne, Australia (Podium Presentation) Award Recipient for the 2018 Excellence in Educational Research Award, awarded by the Sigma Theta Tau International/Chamberlain College of Nursing Center for Excellence in Nursing Education.  

Garner, S. L., Samyappan, J., Cyriac, R., Vidya, P., Selva, Mugalla, D. S. (2020). Simulation evaluation:  Observation versus self-efficacy among nursing students in India. Clinical Simulation in Nursing. 39(C), 55-61.

Garner, S. L., George, C. E., Young, P., Hitchcock, J., Koch, H., Green, G., Mahid, Z., & Norman, G. (2020).  Effectiveness of an mHealth application to improve hypertension health literacy in India. International Nursing Review. 67(4), 476-483. doi:10.1111/INR.12616

Garner, S. L., Wong, J.J., Young, P., Fendt, M., Hitchcock, J., & George, C. E.(in press 2021). Mobile health to improve hypertension and diabetes health literacy among Asian-Indian migrants to Hong Kong.  CIN Computers Informatics Nursing.

Garner, S. L., Koch, H., George, C. E., Hitchcock, J., Green, G., Young, P., Mahid, Z., & Norman, G.  (2021).  Cross Cultural Team Collaboration:  Integrating Cultural Humility in mHealth Development and Research.  Informatics for Health and Social Care.