NURS 764 Week 8 Project: Final Submission and Teaching Portfolio Example

Final Submission: A Helping Babies Breathe Mission Trip That Reinforces the Golden Minute, and the Assembled Teaching Portfolio

Why a Mission Trip Fits the Topic

In the clinical plan, the main obstacle to learning the golden minute was rarity: a student on an American labor unit may never see a baby who needs ventilation. In many low-resource settings, the opposite is true, and birth attendants trained in Helping Babies Breathe face the golden minute often. A mission trip in which senior BSN students support Helping Babies Breathe training lets them teach the skill they learned as juniors, which reinforces it, and lets them see why the first minute matters so much where neonatal deaths are common. Ratekin et al. (2025) reported that in Migori County, Kenya, the neonatal mortality rate in 2021 was about 18 per 1,000 live births, well above the global target of 12, and that after Helping Babies Breathe training at twenty-six health centers, the proportion of non-breathing newborns not ventilated within one minute fell from 12.7% to 6.9%. The skill my students practice on manikins is, in such settings, a daily difference between life and death.

Partners and Principles

The trip would be planned with two partners in western Kenya: a church-affiliated mission hospital with about 3,000 births a year and the midwifery school that places its students there. Both have Kenyan Helping Babies Breathe master trainers on staff. The university nursing program would not run its own training; the hospital's trainers would lead, and the students would assist.

The design follows principles that Lasker et al. (2018) found to be widely shared across twenty-seven guidelines for short-term global health work: host partners, proper preparation and supervision of visitors, needs assessment and evaluation, sustainability and adherence to legal and ethical standards. The authors also found that staff in host countries valued learning in both directions and being treated with respect, and the trip is designed for students to learn from Kenyan midwives at least as much as they help. Billings and Halstead (2016) describe service learning and global experiences as valuable when structured with clear objectives, preparation and reflection, and the plan below includes all three.

Goals Agreed with the Host

Planning would begin a year ahead with a video meeting in which the hospital's nurse manager and master trainers state what they need. For this design, the hospital's priorities are assumed to be three: a refresher for staff trained more than a year earlier, initial training for the midwifery school's final-year students and a system for regular practice after the trainers' attention moves elsewhere. The trip's goals follow these: support two refresher courses and two initial courses led by the master trainers, help set up a practice corner with a manikin on each of the two labor wards, train six local practice leaders to run brief weekly practice and help design the four-month and nine-month skills checks. The trip does not aim to change hospital policy, provide equipment the hospital cannot maintain or provide clinical care.

The Student Team and Preparation

The team is eight senior BSN students who completed the golden minute unit as juniors and passed the six-week recheck, with two faculty members, one of them a certified neonatal resuscitation instructor. Preparation runs over six evening sessions in the semester before travel. Topics include the history and current practice of Helping Babies Breathe, the host hospital's own protocols as shared by the partners, Kenyan culture and health care, basic Swahili greetings, the ethics of short-term global health work, the limits of the student role and the team's faith and service commitments. Each student practices facilitating a Helping Babies Breathe station under faculty observation until they can do so smoothly.

Students will not deliver babies, perform resuscitation on real newborns or give care of any kind. On the wards they observe only with the permission of the patient and the midwife in charge. In training sessions they set up stations, help learners practice under the master trainers' direction, time attempts and record checklist results. All teaching content follows the hospital's materials.

Two Weeks on Site

What Continues After the Team Leaves

The evidence shows that this part matters most. In the Ethiopian cohort described by Sendo et al. (2025), only about a third of midwives were still proficient on the practical examination a year after their pre-service training, down from close to two thirds. Mwilike et al. (2026) followed 210 providers in Tanzania after training in several Helping Babies Survive and Helping Mothers Survive modules and found that knowledge and skills declined across every area, with rural providers losing more in some key obstetric skills, and they recommended regular refresher training. Ratekin et al. (2025) also saw knowledge and skills decline significantly within nine months despite quarterly follow-up training. A single visit, however well run, would leave little behind.

The plan therefore centers on the six practice leaders and the practice corners. Each practice leader agrees to run a five-minute practice with each colleague on the ward every week, logging attempts in a notebook kept with the manikin. Perlman et al. (2020) reviewed large-scale Helping Babies Breathe programs and noted that skills fall off after initial training and that accumulating evidence supports frequent refresher practice to keep them. The host's master trainers will repeat the skills check at four and nine months, matching the intervals in the Kenyan evaluation, and share the anonymized results with the faculty team by video call. The university commits to funding replacement masks and a second manikin through the hospital's own supplier, so that equipment can be repaired locally.

How the Trip Reinforces the Objectives

Teaching a skill is one of the strongest ways to keep it. By coaching dozens of learners through the golden minute, the traveling students practice the same judgments the objectives measure, against the same time targets, in a setting where they can see why those targets exist.

Reflection and Faith

Each evening the team meets for a short reflection guided by three questions: what did I learn from a Kenyan colleague today, what surprised me and where did I see the value of a single life? The trip is offered by a Christian university, and the faculty will invite, not require, students to connect the work to their faith. Scripture describes the first human life beginning when God "breathed into his nostrils the breath of life" (English Standard Version Bible, 2001/2016, Genesis 2:7). Every first breath since has been a gift, and the midwife who ventilates a silent newborn in the first minute is serving that gift. Students are encouraged to notice, too, that their Kenyan colleagues often bring the same conviction to the work and have practiced it far longer. The aim is not to bring rescue from outside but to strengthen the people who are already there in the first minute of every birth.

Risks and How They Are Managed

Several risks need planning. Students could unintentionally become a burden on a busy hospital, needing escorts, translation and attention from staff whose time is already short; keeping the team small, scheduling all activities with the nurse manager and giving the hospital a modest payment for coordination time reduce that burden. Students may feel distress at seeing neonatal deaths, which are more common at the partner hospital than at home; the evening reflections, the faculty's presence and an agreed process for a student to step away from the wards address that. Health and travel risks are handled through the university's study abroad office, including vaccinations, insurance and an evacuation plan. Finally, there is a risk that the trip serves the visitors more than the hosts. The joint reflection on day twelve, the written summary for the hospital and the follow-up skills checks are there so that the hospital judges whether the visit was worth its cost, and the partnership continues only if the hospital asks for it.

Evaluating the Trip

The trip is evaluated at three levels. For the traveling students, a pre-trip and post-trip timed checkoff on the golden minute and a written reflection measure what they gained. For the host, the master trainers' records of attempts at the practice corners and the four-month and nine-month skills checks show whether the practice system took hold. For the partnership, a short survey of the nurse manager and master trainers, written with them, asks whether the visit met the goals they set. Results go to the hospital first and to the university second.

The Assembled Portfolio

The final portfolio combines all six parts under one introduction. Its contents are an introduction explaining the topic and how the parts connect; the topic, bibliography and objectives; the classroom teaching plan with the lecture materials and the video script; the innovative strategies; the clinical teaching plan; the distance learning strategies; and this mission trip design. Three revisions were made in assembling it. The objectives were checked so that the same five appear in identical wording in every part, and the classroom plan's alignment table now includes the clinical and online activities. The innovative strategies paper now names the facilitator preparation needed for rapid cycle deliberate practice, a gap noted in feedback. The clinical plan's section on debriefing after real resuscitations now refers students to the online forum described in Module/Week 7, so the two parts support each other. The portfolio ends with a one-page reflection on what designing it taught me about teaching a rare, high-stakes skill.

References

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed.). Elsevier.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Lasker, J. N., Aldrink, M., Balasubramaniam, R., Caldron, P., Compton, B., Evert, J., Loh, L. C., Prasad, S., & Siegel, S. (2018). Guidelines for responsible short-term global health activities: Developing common principles. Globalization and Health, 14(1), Article 18. https://doi.org/10.1186/s12992-018-0330-4

Mwilike, B. E., Philbert, R., Rimoy, M., Mabada, L., Komba, N., Okade, T., Mwanga, F., Gosse, R., & Ambikile, J. (2026). Long-term knowledge and skills retention following Helping Mothers Survive and Helping Babies Survive training in Tanzania: A mixed-methods follow-up study. Frontiers in Public Health, 14, Article 1824835. https://doi.org/10.3389/fpubh.2026.1824835

Perlman, J. M., Velaphi, S., Massawe, A., Clarke, R., Merali, H. S., & Ersdal, H. (2020). Achieving country-wide scale for Helping Babies Breathe and Helping Babies Survive. Pediatrics, 146(Suppl. 2), S194-S207. https://doi.org/10.1542/peds.2020-016915K

Ratekin, C. S., Auko, E., Wafula, M. M., Omwanda, W. O., Wamae, J., Mudhune, S. A., Rogers, A., Mbeya, J., Ouma, F. O., Njoki, L., Young, W., & Starnes, J. R. (2025). Evaluation of the Helping Babies Breathe programme in Migori County, Kenya. BMJ Paediatrics Open, 9(1), Article e003887. https://doi.org/10.1136/bmjpo-2025-003887

Sendo, E. G., Aga, F., & Gebrewold, L. A. (2025). Retention of knowledge and skills among midwives one year after completing helping babies breathe pre-service training in Ethiopia: A non-randomized quasi-experimental study. Maternal Health, Neonatology and Perinatology, 11(1), Article 15. https://doi.org/10.1186/s40748-025-00201-2