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A 2-week community health clinical experience in Ghana, Africa, provided undergraduate nursing students a study abroad opportunity to expand their cross-cultural skills. Journal entries ( N = 512) of four cohorts were analyzed for common themes using Atlas.ti 7 in this descriptive qualitative study. No emphasis was placed on how to cope with cultural shock in Ghana, nor any attempt made to teach effective coping skills during the trips. Bochner’s ABC cultural learning response model provided the framework for grouping themes. Positive coping skills included the need for control, humor, normalizing, and reframing as well as a need for a break and relaxation. Venting, frustration, and physical ailments were coded as negative responses to culture shock. Due to these findings, student preparation for short-term study abroad should include discussions on effective coping with culture shock during orientation sessions and on-going debriefing.

Background: Reflective journaling has been widely used as an education tool. Minimal research has occurred to determine whether prompted or open format journaling nurtures cultural competence.Methods: The efficacy of journal prompts as a pedagogical tool was assessed in this descriptive study. Undergraduate nursing students (N = 49) reflected on their clinical experiences during 2-week trips to Ghana over 4 years (2013-2016). The 1st, 2nd and 4th trip, students were assigned open reflective journaling. The 3rd trip, students were given prompted questions to answer. Entries were coded using Atlas.ti 7.Results: The prompted format produced shorter entries with less rich and reflective substance. Some entries only allowed for two codes. Unprompted entries provided up to 28 codes.Conclusions: During cross-cultural encounters, unprompted journaling may produce the richest results. When prompts are used, the format needs to be carefully selected to facilitate transformative learning.