Preliminary Insights into International Work Integrated Learning (WIL) Placements in Disability and Student Recommendations for Success

This pilot study explored the experiences of undergraduate students studying disability who undertook a three-week international Work Integrated Learning (WIL) placement in Brunei Darussalam. Presented are the students’ perspectives of the value of the international WIL and its impact on their personal and professional growth. Semi-structured in-depth interviews were conducted and transcripts analysed using a thematic and iterative qualitative approach compatible with phenomenology. Three major themes exploring student experiences emerged: ‘valued experiences’, ‘cultural dissonance’ and ‘personal and professional growth’. Four recommendations relate to ‘selection interviews, comprehensive pre-departure sessions, accommodation, and quality university supervision’. Indicative findings suggest the placement had a valuable and positive impact on the students, increasing their cultural competence and assisting with their personal and professional growth. Additionally, the findings provide further insight on what makes international WIL placements successful and promotes optimal learning.

Research also confirms that students on international WIL undergo a transformative change in their thought processes when they confront their own cultural beliefs and biases when exposed to cultures profoundly different from their own (Mkandawire-Valhmu & Doering, 2012). Peiying et al. (2012), Charles et al. (2014) and Murray (2015) stated that when students are on an international placement they displayed the following characteristics: their cultural sensitivity is increased through cultural dissonance; increased vigilance and adaptation to environment; uncertainty and anticipation; grappling with supremacy; recognising and appreciating differences; and cultural immersion.
It is widely acknowledged that short-term, high quality international WIL can positively influence personal growth and professional competencies (Kearney et al., 2014). The research undertaken by Maynes, Allison, and Julien-Schultz (2013) found that even four years after their international WIL students' 'sense of respect for other people of vastly different life circumstances was evident in the tone, substance and examples they provided in interviews' (p. 160). Stachowski and Sparks (2007) study of over 2000 students, noted several categories that emerged: 'improved relationships with people; stepping out of their comfort zones; increased self-awareness; increased understanding of other cultures; … growth in confidence; [and] greater appreciation of multiple perspectives ' (p. 8). In relation to professional growth the authors note: an awareness of their strengths and weaknesses; an increase in their marketable skills due to them undertaking the unique experience; and their capacity for working with a diverse range of colleagues.
Published studies have presented requirements necessary for students to have successful and positive international WIL experiences (Briscoe, 2013;Gonsalvez, 2013;Graham et al., 2014). Requirements include being well organised; activities clearly linked to academic content (Gonsalvez, 2013); student safety and staff/student ratios (Graham et al., 2014); and fostering cultural safety (Briscoe, 2013).
International WIL can be time-consuming for students and not all higher education programs have the capacity to offer the option within their course structure (Maynes et al., 2013). The number of hours that students are required to undertake WIL makes the overseas option complex and often costly to implement (Maynes et al., 2013) particularly, if clinical placements with regulatory requirements are needed (Read, 2011). Cost is the most often cited barrier to participation in international WIL. This includes funding issues around accompanying staff salaries and travel costs (Read, 2011). For students this includes the direct cost of plane tickets, accommodation and living expenses, but also includes the loss of income they may sustain by not working in paid employment while overseas (Browne et al., 2015). An enormous amount of time and effort is required from university staff to arrange logistics for students to be placed overseas with additional planning and preparation required if the destination has a risky or unstable political climate (Maynes et al., 2013).
Australia is a multicultural country and one of the most culturally and linguistically diverse (CALD) in the world. In 2018, 29% of Australia's resident population were born overseas (Australian Bureau of Statistics, 2019). Consequently, in order to provide safe, high quality human services, it is important for professionals to be appropriately responsive to cultural and linguistic diversity (Perry et al., 2015). Training and educating professionals in cultural competence is necessary to develop a culturally sensitive, congruent and responsive human services workforce (Alexander, 2008). International WIL supports this opportunity. According to Smith-Miller et al. (2010) 'improving cultural competence in an increasingly multicultural world has become an ethical imperative' (p. 18), and universities are increasingly using international WIL as a means of expanding cultural competence in students. Some literature also questions the extent of the benefits derived from international WIL. Harrowing et al. (2012) report only modest benefits were found and cautions that, 'a few weeks spent in another culture undoubtedly provide valuable insight into different realities, but it does not make one an expert on the lived experience of Africans, African Americans, Spanish speakers or immigrants to North America' (p. 500).
The overwhelming majority of research studies on international student WIL experiences involve students undertaking education, social work, nursing or health sciences. However, there is a paucity of studies conducted with students undertaking disability degrees and engaged in disability specific international WIL. Evaluating and understanding student perspectives of the value of international WIL and the impact on their professional, personal development and career competencies is crucial for the improvement and sustainability of such opportunities. Therefore, the aim of this preliminary explorative study was to examine the experiences of undergraduate students studying disability who undertook a three-week international WIL placement in Brunei Darussalam to identify recommendations for successful international placements in this growing sector.

Background of the WIL Placement
The students undertook their placement in an autism centre which caters for individuals of all ages, although most ranged in age from four through to 20. The centre is run by parents and family members to enable people on the autism spectrum to reach their full potential and to raise awareness about autism in the community. Students spent their first three days at the centre in training sessions to learn about the specific methods of teaching the centre uses. The centre has a very structured approach and uses strong visual reinforcement. The students supported the people in the centre in all aspects of their daily lives including academic skill building, personal hygiene management, fitness/sport training, cooking, cleaning, and for those old enough, competency-based training to gain employment skills.

Academic Learning Outcomes
During the placement, the students gained a breadth of knowledge about autism. They learned early intervention, speech pathology techniques and how to work with both verbal and non-verbal people on the autism spectrum. They also discovered that the many misconceptions about people on the autism spectrum (e.g. they cannot learn, they do not experience a full range of emotions, their behaviour cannot be modified, they do not want friends, etc.) are simply not true. The students learned that people on the autism spectrum are just like everyone else; they simply need extra support.

Methodology
Ethics approval for the pilot study was obtained from Flinders University Social and Behavioural Research Ethics Committee (Ethics Approval Number 7234). A total of five of eight potential participants scheduled interviews. The participant sample included four females and one male whose ages ranged from 19-21 years. All were enrolled in the Bachelor of Disability and Developmental Education (BDDE) in South Australia. Despite the limited number of participants in a qualitative pilot study of this nature, the richness of the data is more important than the number of participants. Data was collected via semi-structured interviews which were roughly 45-60 minutes in duration. Transcripts were imported into NVivo 10 and analysis was done using a thematic and iterative qualitative approach. Analysis linked to phenomenology was used in order to make meaning of the lived experience of the students (Srivastava & Hopwood, 2009). Thematic analysis was used to identify and describe themes that occurred in the data (Braun & Clarke, 2006) from individual interviews and across interview sets (DeSantis & Ugarriza, 2000). Nodes were created in NVivo by the researcher to highlight key themes (Braun & Clarke, 2014). Each transcript was independently analysed by the supervision team in order to identify, discuss and reach consensus on the final themes.

Results
Three themes emerged in respect to the participants' experiences of the international WIL: (1) valued experiences; (2) cultural dissonance; (3) personal and professional growth. Each theme is described below.
Valued experiences: All participants described positive experiences with the staff from the disability services placement site with students appreciating the staff's ability to speak English, their friendly and open approach, their passion, encouragement to ask questions, trust, and opportunities they gave students to participate, learn and lead activities. One student exclaimed, 'If you made a mistake it was okay. I loved that attitude to everything'. In fact, they found the experience so rewarding that they proposed that experiencing international WIL should be mandatory: 'I feel like travelling [overseas] and working in a centre for people with disability should be compulsory [for BDDE students]; I honestly think it should be. I wish it was. It's just incredible' (Student B). All five participants were overwhelmingly positive about their experience using words such as, 'great,' 'amazing' and 'incredible' to describe their experience. The participants commented on how grateful they were to be given the chance to work with remarkable people overseas while learning about their culture. Another student declared, 'We got to work with amazing kids, and we got to be in a [Muslim] country where [we got to] see a beautiful side … of a culture that is so taken for granted and so misunderstood' (Student D).
Cultural dissonance: All five participants indicated that their attitude toward other cultures had been impacted on as a result of their international WIL. Two advised that their perception of Muslim people was altered from their experience. One student commented that their exposure to Muslims helped them to see how similar Muslims were to non-Muslims and how this insight helped them to acknowledge that they held an incorrect stereotype of Muslims prior to placement.
Personal and professional growth: Four participants commented that undertaking the placement developed their professional confidence by allowing them to work with families, by receiving feedback and by providing them with access to a different culture. 'Being able to get feedback from … the staff and supervisors saying, "you're doing good" … [boosted your] confidence …' (Student A). Another commented, 'I think that placement made me a lot more confident in who I am as a person … [and] … it made me realise that the things that I'm learning I can do' (Student E). An additional student commented on how much and how quickly they learned things while away because they were forced to step outside of their comfort zone, stating; 'I learnt that much in three weeks that it felt like I was away for three months or had studied for three months. It was just so compact' (Student C).
Participants described having a positive and rewarding experience that was, '… worth every cent it cost' (Student D). They were very grateful that they were given the, 'once in a lifetime opportunity' (Student D) to undertake international WIL. The international WIL played an important role in confirming students' career direction and identifying areas of focus for future study and job opportunities: '[The placement] … actually proved to me that … [disability] was the field I wanted to be in' (Student D).
Two students explained how the placement experience also impacted them personally: 'I feel like my perspective on everything would be so different [if I had not participated in this international WIL placement]' (Student C) and: 'I went in with nothing and came back with so much. … It's just incredible' (Student B).
Selection interviews: Selection interviews play a critical role in identifying inherent student qualities that influence/enhance international WIL placement experiences in the disability sector. Each participant provided insight into what they believed were beneficial mindsets for future students in order to get the most value out of international WIL. These include Comprehensive pre-departure sessions: The importance of the pre-departure information sessions was highlighted by four participants. Such sessions prepare students for what to expect, how to dress and how to act in order to be respectful of the Bruneian culture and religion. In addition to the sessions, family dinners held prior to departure were identified as beneficial because they allow the students and families to get to know each other, develop rapport and facilitate an opportunity for family members to ask questions of the university supervisors and ease any concerns. One student advised, 'Some families were worried, some were anxious and [the dinners helped to make some of the family members] … feel a bit better' (Student C).
Accommodation: Access to internet was identified as critical to enable students to maintain contact with family and friends and to continue other university commitments during this period: 'Internet access is important, especially because [university] assignments [were] … due whilst we were away' (Student E). The value of single rooms was acknowledged '[having a single room] …. was good because you kind of need a bit of a debrief, personal debrief, you know … You just wanted to just be by yourself and relax' (Student C). Students liked and recommended having all the single rooms located near each other in order to help facilitate making plans quickly and easily with other students. They also believed having good air-conditioning in their accommodation was beneficial as they were not acclimatised to the hot and humid weather and they would get a good night's sleep in an air-conditioned room. Having the accommodation in a central location was essential for the group, chiefly because of the inherent issues with lack of public transportation.
Quality university supervision: Each student stressed the importance of quality university supervision. Desired supervisor attributes included accessibility, openness and approachability with 'a literal open-door policy' (Student B) while on placement.
Additionally, supervisors needed to establish professional relationships with placement students, demonstrating good communication, knowledge and insight into the needs of each student: '[They should be able to] pop in and say, "Hey, you look a little bit tired. You look a little bit stressed; do you want to talk about something?" (Student C). The ability to understand the unique needs of each student was highlighted, including knowing 'when they need to step in for the University and when they need to step in for personal support' (Student D). Respect and acknowledging students as adults in an adult learning environment was emphasised, together with working alongside students in the placement site to model appropriate practice, communication and problem-solving skills.

Discussion
All five participants described having an overwhelmingly positive and valuable learning experience and they indicated that the placement helped break down their previously held stereotypes of Muslim culture and impacted positively on their attitude toward other cultures. The participants' direct exposure to living and working in a Muslim country, in addition to having very positive, friendly and affirming interactions with the staff in the disability services, helped to alter their personal perceptions. These results concur with the findings of numerous other studies (Charles et al., 2014;Greatrex-White, 2008;Jones et al., 2012;Maynes et al., 2013;Tuckett and Crompton, 2013) which highlight that students, through international WIL, learn that, despite cultural differences, everyone is, 'connected as human beings,' (Greatrex-White, 2008, p. 8). Consequently, it can be inferred and asserted that this particular international WIL helped increase the cultural competence of students.
While in Brunei, the participants reported at times feeling outside of their comfort zone. Four of the participants found this to be the case when the locals stared at them and/or wanted their photos taken with the 'white' students. At times the participants struggled with the local food, the pace of the placement activities and with the hot and humid weather. A number of other studies have discussed how it is necessary for students to experience the discomfort of being outside their comfort zone in order for them to achieve positive growth and awareness in their cultural understanding (Charles et al., 2014;Murray, 2015;Smith-Miller et al., 2010;Stachowski & Sparks, 2007).
Some of the cultural norms of daily life in Brunei highlighted the awareness of the participants' own cultural norms and led to further personal growth. Three of the participants found the most striking difference in cultural norms to be the amount of physical contact the centre staff were permitted to give their students. As this 'hands-on' approach was in direct contrast to the approach the students were used to in Australia, it initially made them apprehensive. However, once the students adjusted to the local practice, they were able to accept it and acknowledge some of its benefits. These findings concur with other studies that show students develop an awareness of the host culture and simultaneously develop an awareness of the structures and practices embedded in their own culture as they were exposed to others who were different to them and begin to become comfortable working with others who do things in a different way (Charles et al., 2014;Greatrex-White, 2007;Levine, 2009;Mkandawire-Valhmu & Doering, 2012).
The professional confidence of students in the study appeared to increase over the placement. Influencing factors included exposing the participants to different culture, routines and social mores in a safe, structured and supported context. It also gave the students the opportunity to work with families in a culturally different disability services setting and to receive feedback from their university supervisors. These results are broadly consistent with the Kearney et al. (2014) who found that students' confidence and professionalism grow by overcoming challenging experiences. In addition, the study by Stachowski and Sparks (2007) also found that students, while overseas, are more open to experiencing personal and professional growth, to building their self-confidence, and to adapting and acquiring new practices, ideas and beliefs.
A novel finding in this study is the detail the participants provided around what they considered to be suitable accommodation. As mentioned, the participants endorsed having single rooms as they needed their own space at the end of long days being together but having the rooms located next to each other was beneficial as it allowed them to make plans with each other quickly and easily. Airconditioned rooms were seen as vital and having the accommodation in a central location gave them the ability to walk to restaurants, grocery stores and shopping centres. This gave them freedom of choice and negated the issue with the lack of available public transportation in Brunei. Having a reliable Wi-Fi connection available in their accommodation gave them a sense of familiarity in an unfamiliar country by allowing them to keep connected to each other, their supervisors and their families back home.
The participants described their experience as positive, rewarding and well worth the financial cost. Student cohorts in research from Curry (2011), DeDee andStewart (2003) and Critchley et al. (2009) reported similar outcomes when describing their participants' international WIL experiences. Students in this research reported their experience was transformative, unforgettable and life changing.
Three participants expressed how much the placement in Brunei impacted them personally by 'opening their eyes' and changing their 'perspective on everything'. Four participants stated the placement increased their confidence and contributed to their professional development. Smith and Curry (2011) and DeDee and Stewart (2003) reported gains in their participants' professional role, international perspective, personal development and intellectual development.
Recommendations include conducting selection interviews to identify traits which were identified as being open-minded and flexible, not making comparisons with the home country and openness to fully embrace every opportunity. Comprehensive predeparture sessions set expectations around culturally respectful dress and group behaviour, with dinners with the students' family members advised as they supported students to develop rapport and facilitated an opportunity for family members to ask questions of the university supervisors and ease any concerns.

Preliminary Implications for Future Practice
As Australia is a multicultural country, it is imperative that allied health professionals are trained and educated to become culturally competent in order to provide culturally sensitive, congruent and responsive healthcare (Alexander, 2008). Many Australian students want to undertake international WIL because of the skills and abilities it promotes (Gamble et al., 2010). The experiences of participants in this study can shed light on what makes international WIL successful and what facilitates optimal learning. Findings highlight the need for international WIL to be thoroughly planned and well supervised, ensuring students have adequate living arrangements and are open-minded, flexible and non-judgemental.

Conclusion
Participants in this pilot study described their experiences of undertaking disability-specific international WIL in Brunei Darussalam. Participants reported the experience was positive and valuable and they believed the experience increased their cultural competence. Participants' personal and professional growth was aided by being, 'outside their comfort zone', by being exposed to a different set of cultural norms and by overcoming challenging experiences. The participants provided their opinions on the local food, the weather and accommodation. They also advised that the disability services centre and international WIL experience exceeded their expectations. They reported the experience impacted their professional practice by giving them the confidence to empower people living on the autism spectrum to achieve their goals and by providing them with insight into how the Bruneian culture works with disability. Participants provided recommendations to future students and to university course administrators who may be considering implementing international WIL. Their recommendations include holding comprehensive pre-departure sessions; having quality university supervision; and ensuring, through an interview personality vetting process, that the students chosen to undertake an international WIL are open-minded, flexible and nonjudgemental. With international WIL opportunities increasing in number, it is vital to undertake research that aims to identify what makes placements successful and what promotes optimal learning for students.