
While working alongside nursing students at the Universidad de las Américas (UDLA) in Quito, Ecuador, Shoreline College student Serena Wilber noticed some differences between nursing practices in Ecuador and the United States. Nurses in Ecuador, for example, often cared for more patients and had less access to advanced medical technology than their American counterparts. Yet despite the contrasts, what stood out were the similarities.
“Although nursing practice can look very different depending on the country and available resources,” said Serena, “the importance of teamwork, adaptability, communication, and compassionate patient-centered care remains universal.”
This past June, Serena was one of several nursing students who gained firsthand experience with global healthcare and nursing education through a Shoreline College study abroad program called Social Determinants of Health in Ecuador.
The program was developed in 2023 with funding from a State Department IDEAS grant (Increase & Diversify Education Abroad for Students), which supported the creation of a short-term, faculty-led study abroad experience addressing a United Nations Sustainable Development goal. This trip focused on the goal of Good Health & Wellbeing.
Designed specifically for nursing students, the program provides an international learning opportunity that fits within their demanding schedule of coursework and clinical training.
“We really tailored the program to be accessible to nursing students and also relevant to their academic and professional goals,” said Colleen Ferguson, Associate Director of Global Learning and Engagement at Shoreline College.
While the program is restricted to nursing students, it is not limited to students at Shoreline College. The program is open to nursing students throughout the region, and, since its launch, participants have included students from Olympic College and the University of Washington Bothell. Organizers hope participation will continue to expand.
“My goal is to make this a statewide opportunity for nursing students,” said Colleen.
The program’s central focus is to understand how social, economic, geographic, and cultural factors influence health outcomes. For this, Ecuador provides a compelling case study.
“The students are going to Ecuador because Ecuador made a conscious decision to change accessibility to healthcare in their country,” said Colleen. “And they were shockingly successful.”
Ecuador’s improvements are indeed impressive. Over the past two decades, they have dramatically improved the effectiveness of their healthcare system, earning international recognition for their progress. In a global ranking of healthcare efficiency, Ecuador moved up from 111th place to 20th in only 14 years.
Students explore this success story from multiple angles. They attend lectures, tour simulation facilities, and spend time learning alongside their Ecuadorian peers at UDLA. Participants also learned about traditional healthcare practices from a local healer; joined a physician on a rural healthcare brigade bringing care to communities without local clinics; and met with patients, families, and staff at a childcare center for children with Down Syndrome.

“I really enjoyed working with toddlers with Down Syndrome and taking part in a discussion with their parents,” said Shoreline student Molly Tibbott. “I could tell how much effort the parents give their children to create a brighter future for them.”
Alongside these experiences, students also visited several cultural and natural points of interest, providing additional context and insight into the unique challenges of delivering healthcare in Ecuador. For many participants, the trip provided a new perspective on their chosen career.
“I have a deeper appreciation for what it means to advocate for the vulnerable populations we work with, the power we have as healthcare professionals in making change for our communities and being creative in addressing the challenges and barriers our patients face in accessing care,” said nursing student Bimmy Kaur.
Given that Ecuador and the United States both face challenges related to economic inequality and disparities between urban and rural healthcare access, the experiences gleaned by participants in this program provide new perspectives, and possibly new solutions, to those challenges here at home.
“The healthcare experience I gained from this trip was eye opening,” said Molly. “To any nursing students considering the trip to Ecuador, I would say to go and see for yourself what there is to be learned from the culture, the history, and the people.”



The Social Determinants of Health in Ecuador program runs every summer, and scholarship are available to offset the cost. Interested students can visit the program webpage to learn more and find out about upcoming information sessions.
