what causes culture shock essay

Essays About Culture Shock: Top 5 Examples and 7 Prompts

Writing essays about culture shock promotes awareness, improves character, and fosters meaningful interactions; reading our top examples and prompts to get started.

Two things stood out when I visited Thailand: the beautiful tourist destinations and the country’s food. I enjoyed the meals and snacks, especially  Roti Sai Mai . It’s a sweet candy floss rolled into a salted roti sheet. My peers, however, liked eating Nhon Mhai or silkworms sprinkled with pepper and soy. I knew the country had exotic foods, but it still shocked me. 

Culture shock happens when one is unfamiliar with the environment and culture of a place they’re visiting. People who usually experience this are international students, migrant families, and first-time travelers like myself. An effective way to promote awareness of its  symptoms and stages  is through writing essays about the subject.

5 Essay Examples

• 1. What Is the Culture Shock? By Anonymous on EduBirdie.Com
• 2. Long Essay on Culture Shock by Prasanna
• 3. Cultural Shock and Adaptation by Anonymous on GradesFixer.Com
• 4. Culture Shock — What Is It by Anonymous on IntervarsityChicago.Org
• 5. My Experience of Culture Shock in the United States by Anonymous on GradesFixer.Com

1. Culture Shock: Defined

2. symptoms of culture shock, 3. the phases of culture shock, 4. how to overcome culture shock, 5. factors and effects of culture shock, 6. is culture shock normal, 7. my personal experience of culture shock, 1. what is the culture shock  by anonymous on edubirdie.com.

“Culture shock is the result of national culture. Everyone has a culture which he or she grows, works, and lives. Because of that difference, people are having trouble to adapt new culture.”

In this essay, the author uses students studying abroad as an example to explain culture shock. They mention that culture shock is inevitable even if students prepare themselves for the problems they may face when moving to another country. As a result, students become unfocused and stressed and develop psychological problems.

According to the writer, culture shock is an insurmountable problem, but there are ways to reduce its impact, especially on students. It includes orientation programs from universities, research about the new culture they will encounter, and human interaction. You might be interested in these essays about city life .

2. Long Essay on Culture Shock  by Prasanna

“Traveling to a foreign country is one of the best ways to step outside your monotonous life. The fear of facing unfamiliar situations holds many people from stepping out of their comfort zone. When you reach a new country, you will have the opportunity to see and experience things that you were longing for, have fun and enjoy the atmosphere that you can’t do in your home country.”

Prasanna describes culture shock’s many benefits that significantly improve one’s life. For example, it assists in breaking routines so one can adapt to others’ customs. It leads to individuals being more flexible and expanding their horizons. 

Culture shock also helps build self-confidence and overcome challenges. People make new friends and create new experiences by exposing themselves to unfamiliar cultures, places, and groups. The new knowledge about a foreign place dramatically influences one’s personality and promotes self-growth. Ultimately, Prasanna believes that culture shock is difficult at first, but one becomes comfortable with the changes around them as the day goes by.

Looking for more? Check out these essays about globalization .

3. Cultural Shock and Adaptation  by Anonymous on GradesFixer.Com

“… The differences of how people live, their beliefs, values are rather obvious. We not only find no evidence of convergence – we actually find that the gap between the value system of rich and poor countries have been growing, not shrinking, during the past 20 years.”

This essay contains various quotes from people knowledgeable about culture shock, such as Michael Minkov, the author of  “Cultural Differences in a Globalizing World.”  The writer says that traveling abroad is more than just enjoying the sights, festivities, and food. It’s about learning and understanding how its people live — the travelers’ difficulties in understanding these lead to culture shock. Since this is a broad and sensitive topic, the author believes that people should learn about the culture and its differences to know its causes and develop effective methods to overcome them.

4. Culture Shock — What Is It  by Anonymous on IntervarsityChicago.Org

“Culture Shock is the disorientation and change that is experienced after an international relocation… You will feel as if you are in the wrong place; everything will appear abnormal and you will often find things hard to comprehend.”

The author defines culture shock as mental confusion brought on by moving to a foreign country, locale, school, and workplace. Various factors contribute to culture shock, and its effects differ from one person to another. For students and employees, culture shock makes them unproductive and tired. 

The essay further explains that the usual cause of culture shock is homesickness. People feel various indicators like insomnia, anger issues, irritation, and many others. Their advice to readers dealing with culture shock is to look for its causes to handle it properly to avoid adverse effects. You might also be interested in these essays about culture shock .

5. My Experience of Culture Shock in the United States  by Anonymous on GradesFixer.Com

“Many of the customs of the new culture may seem odd or uncomfortably different from those of your home country. Being in a new and unfamiliar place can be challenging even for the experienced traveler, and it is normal to feel frustrated and isolated.”

Being from Kazakhstan and using a Hollywood movie as a basis for American life, the author has no idea that pursuing their dream of living in The Land of the Free will give them culture shock. The writer discusses three significant differences between their home country and America.

First, compared to their native land, where people only befriend those they trust, Americans are approachable and make easy friends with strangers. Second, privacy and personal space are nonexistent in America. Lastly, Americans’ ideas of equality spill into how they talk and dress.

7 Prompts for Essays About Culture Shock

Use this prompt to discuss culture shock by talking about its literal meaning, experts’ views, and your idea of it. Then, pick what’s consistent across these varying explanations to create a comprehensive definition of culture shock. Add relevant citations from reliable sources to strengthen your statements and make the essay more informative. 

If you find this topic complex, simplify it and write a five-paragraph essay instead.

Some common symptoms of culture shock are feeling isolated, bored, and irritated. However, it differs in the stage, cause, or degree of culture shock a person has. For this prompt, briefly discuss the definition of culture shock and then identify its symptoms. Expound on each stage’s indicators and how long a person typically goes through these symptoms. The essay must also explain how these signs differ from one individual to another.

There are  four stages of culture shock : honeymoon, frustration, adjustment, and acceptance. Explain each stage and focus on what causes an individual to transition from one phase to the next. Add how long each stage lasts and what feelings are involved. Include examples so readers can better understand each stage.

Certain situations do not allow an individual to return to a familiar environment to get rid of culture shock. In this prompt, center your essay on ways to help people cope with culture shock. Search for effective ways to adapt to the changes, such as developing new hobbies and making friends in the new place. 

Climate, language, social roles, values, and unspoken rules are some factors that contribute to culture shock. For this prompt, briefly explain culture shock and list its common causes to help the reader verify if they’re experiencing this phenomenon. Then, discuss how these factors lead to culture shock by offering examples and include some of its positive and negative effects.

To write this prompt, you need to find reliable references such as demographic statistics to determine the number of people experiencing culture shock worldwide. After gathering data, analyze and discuss your findings. 

Remember to answer the question prompt and summarize your conclusions at the end of your essay. Here’s an example statement: Based on research , 85% of international students experience culture shock, and their top problem is adjusting to the country’s language.

Share a story of your travel or move to another location where you experienced culture shock. Write about the reason for your transfer and describe where you came from versus where you moved to. Include how long you stayed in the place and what culture shock symptoms you felt. Add how this experience affected you and your expectations whenever you visit a new location. If you are interested in learning more, check out our essay writing tips !

Maria Caballero is a freelance writer who has been writing since high school. She believes that to be a writer doesn't only refer to excellent syntax and semantics but also knowing how to weave words together to communicate to any reader effectively.

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6.1: Introduction to Culture Shock

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Introduction to Culture Shock

In your reading of this textbook thus far, we have discussed many theories and principles to help you understand many dynamics of intercultural communication. But understanding intercultural communication is not the same thing as experiencing it. To experience intercultural communication, one needs to get off the couch and set foot into a new and unfamiliar culture. When a person moves from to a cultural environment that is different than their own, they often experience personal disorientation called culture shock. Culture shock refers to the anxiety and discomfort we feel when moving from a familiar environment to an unfamiliar one. In our own culture, through time, we have learned the million and one ways how to communicate appropriately with friends, family members, colleagues, and others. We know how to great people, when and how to give tips, whether to stand or sit, how much eye contact to make, when to accept and refuse invitations, how to understand directions, whether others are being sarcastic or not, how holidays are and are not celebrated, how to shop for and prepare food, and generally how to communicate verbally and nonverbally in any given social situation. When we enter a new culture, many of those familiar signs and signals are gone, leading us to feel helplessly lost in many circumstances.

The ABC's of Culture Shock

Culture shock is first and foremost an emotional response to a change in our culture environment. But it also impacts how we act and how we think. The ABC's of culture shock refer to the affective, behavioral, and cognitive changes brought on by culture shock. The affective dimension of culture shock refers to the anxiety, bewilderment, and disorientation of experiencing a new culture. Kalervo Oberg (1960) believed culture shock produced an identity loss and confusion from the psychological toll exerted to adjust to a new culture. The behavioral dimension refers to confusion over behaviors of people in the host culture. We don't understand why people are behaving they way they are in certain situations and we are not sure how to act appropriately. The cognitive dimension refers to our inability to interpret our new environment, or understand these "bizarre" social experiences.

Underlying Factors

Over the past several decades, there have been numerous peer reviewed, scholarly studies documenting the effects of culture shock. The research suggests that nearly everybody who enters a new culture will experience some form of culture shock, but not everybody experiences culture shock the same way. How long culture shock lasts and the degree to which it is felt will vary according to several underlying factors. One of the most important factors is motivational orientation . Some people travel willingly and are excited to enter a new culture. Students who decide to study abroad, travelers who want to explore the world and families who go on vacations provide few examples. These groups generally have a high motivational orientation and generally have an easier time adapting to culture shock. By contrast, others enter a new culture reluctantly or unwillingly. According to the United Nations High Commissioner for Refugees (UNHCR), there are 70.8 million forcibly displaced people worldwide. These include refugees, asylum-seekers, and internally displaced people. To put that number in perspective, that is 1 out of every one hundred people on the planet. This is the highest number in human history and it is only expected to grow as war and conflicts continue, and catastrophic climate change threatens to make many parts of the world uninhabitable in the near future. These people generally have a low motivational orientation as they do not want to leave their home cultures but do so because their very survival depends on it.

When I was in graduate school in San Francisco, I took a semester off and traveled for 4 months through several Asian countries. On that trip, I met a German woman while on a boat from Sumatra to Malaysia. We traveled together up to Thailand before parting ways. Months later, she came to visit and later moved into my apartment in San Francisco. Eventually we married, and have been together ever since. But back in those days in San Francisco, we had a roommate who saw our relationship develop firsthand. He wasn't having much luck with the dating scene in San Francisco and decided that he, too, would like to meet a "European girl." So he set off for a month to Thailand and India, hoping he would find "the girl of is dreams." This anecdote speaks to another underlying factor, personal expectations . People with high expectations for their cultural experiences tend to struggle more with culture shock. Those who travel with an open mind and heart, who take the experiences as they come in a more spontaneous way tend to adapt better. Needless to say, my former roommate did not find his ideal partner and returned home sharing more stories of frustrating experiences rather than enriching ones.

When we travel to a new culture, the cultural distance between our home culture and host culture impacts our level of culture shock. This distance can be physical, but more importantly, cultural distance refers to the degree of difference in culture between the known, home environment and the new one. When we travel to destinations where people speak a different language, have different racial features, practice a different religion and have significantly different customs and traditions, we typically feel a greater degree of culture shock. As someone born and raised in Northern California, I experienced much more culture shock when I traveled to India than when I visited Vancouver, Canada.

Another factor that influences the degree of culture shock is sociocultural adjustment , which refers to the ability of the traveler to fit in and interact with members of the host culture. The level of sociocultural adjustment largely rests on the hosts attitudes toward visitors to their culture. One attitude of hosts towards tourists is retreatism. Retreatism basically means that hosts actively avoid contact with tourists by looking for ways to hide their everyday lives. Tourists may not be aware of this attitude because the host economy may be dependent upon tourism. Such dependence could possibly force the host community to accommodate tourists with tolerance. Hawaii is a place that depends heavily on tourism and often uses various forms of retreatism to cope with the tourist invasion. Several students have mentioned that other than people who worked at restaurants or on tourist excursions, they didn’t see many locals when vacationing in Hawaii. Another attitude of hosts towards tourists is resistance . This attitude can be passive or aggressive. Passive resistance may include grumbling, gossiping about, or making fun of tourists behind their backs. Aggressive resistance often takes more active forms, such as pretending not to speak a language or giving incorrect information or directions. In the summer of 2019, Barcelona Mayor Ada Colau pledged to reduce the number of tourists, cutting cruise ships and limiting expansion of its airport. These actions came in response to an incredible surge of tourism. As The Guardian reported in 2016, the number of visitors making overnight stays in the city increased from 1.7 million in 1990 to more than 8 million in 16 years. That’s an astonishing increase for a city that is not as big as other European equivalents, such as Paris or London, and where many of the major tourist sites such as Sagrada Familia and Parc Güell are in residential areas where space to expand simply doesn’t exist. Further, traveling can be expensive, and travelers are often—but not always–more economically and socially privileged than their hosts. This dynamic can lead to power imbalances between hosts and tourists. Not all host attitudes are protective or negative. Some communities may capitalize on tourism and accept it as the social fabric of their community. Other communities actively invest money to draw tourists as a way to create economic well-being. This attitude is called revitalization. Residents do not always share equally in the revitalization, but sometimes it does lead to pride in the re-discovery of community history and traditions. Dolly Parton’s “Dollywood” located in Pigeon Forge, Tennessee was created as a way to revitalize a community that she loved much as eco-tourism is a revitalizing force in Costa Rica.

Of course, individual personality attributes play a factor in how well one copes with culture shock. Generally speaking, people with greater tolerance for uncertainty and ambiguity respond better to unknown and unanticipated experiences that occur when encountering other cultures. Those who are inflexible or set in their ways tend to struggle more with culture shock. Experience matters here. First-time travelers are likely to experience more culture shock simply because of the novelty of the situation. Experienced travelers have experienced culture shock in the past and have developed coping mechanisms when they find themselves in that situation again. In 2017, I found myself hopelessly lost walking inside the Medina in Fez, Morocco. The Medina is a walled city formed in the 9th century. It is home to the oldest University in the world. The Medina consists of over 9,000 unmarked narrow alleyways. I had been walking for nearly 2 hours trying to get back to my guest house. I asked dozens of people for help, but due to language and cultural barriers, I was having no luck. I had been warned that tourists shouldn't walk through the Medina alone at night, and as night began to fall, I started to wonder if I would ever find my way out of that incredibly complex labyrinth. Fortunately, this wasn't my first rodeo, as the saying goes. I had previously traveled to 47 different countries on 5 continents. I hiked a volcano alone in the middle of the night in Panama, trekked to the glacial source of the Ganges River in India, sat beside burning human bodies at cremation ceremonies in Nepal, and endured harrowing bus rides on roads cut from cliffs in the Andes of Bolivia. Drawing on those past experiences I didn't let culture shock get the best of me and eventually found my way back home.

Travelers and Tourists

How one travels into a new culture can significantly impact the degree of culture shock one experiences. While the words "traveler" and "tourist" may seem synonymous, to those in the travel community, the implications differ greatly.

Travelers are intellectually curious. They desire to explore new places, taste new foods, meet new people, and immerse themselves in cultures that are different from their own. Travelers prefer to ride in local busses or trains, eat in local markets, and stay in small guest houses, run by local families. Travelers take an interest in their new surroundings by learning the language (or at least a few phrases) and customs of the new culture. Travelers typically travel alone or in small groups. Travelers are spontaneous. They may have a general travel plan, but are willing to deviate from it as opportunities and diversions arise. Travelers attend local festivals and gatherings and share in the traditional celebrations of the host culture.

Tourists are more interested in cultural exploitation rather than cultural exploration. A tourist would rather spend all day on a tourist beach than exploring a local, hidden beach. Tourists are more comfortable eating familiar foods at multinational restaurant chains like McDonalds or KFC. Tourists stay in large hotels specifically designed for tourists. They appreciate all-inclusive resorts like Club Med and often miss sleeping in their own bed. Tourists appreciate the convenience of air-conditioned tourist busses and look to spend their days with other tourists on guided tours. Tourists would rather go on a group tour rather than venture out on their own. Tourists like to follow a strictly regimented plan, with little opportunity for deviation. That way, they can see as many famous sites in as short amount of time as possible. Tourists tend to engage in culturally simulated cultural experiences rather that authentic ones. For example, tourists will go to performances held in the ballroom of their hotels where the only other guests are other tourists. The performance usually entails locals dressing up in traditional garb, singing and dancing for tourists, before returning to their day to day lives. Typically, the only locals that tourists meet are those who work in the tourism industry and serve them.

Tourists generally have a filtered exposure to the other culture, while traveling in national groups largely isolated from native communities. Because of the short time frame and the lack of in-depth exposure to the new culture, tourists normally have an unproblematic relationship to the culture, often experiencing it in a positive light, if perhaps somewhat exoticized. On the other hand, some studies have shown that tourists may have ethnocentric views reinforced. That may occur because tourists, living in an "environmental bubble" (Cohen, 1972), see only selected aspects of a culture. The aspects of the culture encountered (food, dress, festivals) do not provide a comprehensive understanding of the culture as a whole, as they represent outward manifestations of the culture, not its hidden values and beliefs. The result can be that tourists and representatives of the host culture do not see each other in their entirety as human beings:

The mass tourist travels in a world of his own, surrounded by, but not integrated in, the host society. He meets the representatives of the tourist establishment — hotel managers, tourist agents, guides —but only seldom the natives. The natives, in turn, see the mass tourist as unreal. Neither has much of an opportunity to become an individual to the other (Cohen, 1972, p. 175).

This example applies to mass tourism. Cultural tourists, interested primarily in historical and artistic aspects of a country or region, may gain a fuller picture of the culture (Cohen, 1972). It's more likely in that case that the tourists will have prepared for the visit through some degree of study of the history and geography of the region. Optimally, that would include learning basics of the language as well.

Stereotypical images of a culture may be perpetuated through a desire on the part of the host country to accommodate tourist expectations. That may in fact be a practical necessity, if the tourist industry constitutes a major contributor to a region's economy. Hua (2013) provides the example of how topless dancing, a traditional aspect of Zulu culture, has been affected by the tourist industry (see sidebar).

Topless Zulu dancers: Only for tourists?

Naidu (2011a, 2011b) investigates the 'topless' dance tradition of Zulu girls in a cultural village in KwaZula Natal, South Africa, and perceptions of indigenous cultural bodies in tourism. In the cultural village reported in Naidu's study, a small number of Zulu-speaking girls took part in a Zulu dance as 'ethnic' performers. As unmarried virgins, they wear no tops, only beaded skirts and some jewellery when dancing. However, although 'topless' has been a tradition for Zulu girls, things are very different now. As reported by two girls interviewed by Naidu (2011b), girls nowadays do not have to dance 'topless' to show that they are unmarried. Instead, they only do it at home and when there is a special celebration. Nevertheless, the girls feel that this is what tourists want to see and dancing 'topless' is a business exchange, despite the fact that they find it somewhat awkward when dancing in front of and posing along with tourists (Hua, 2013, p.88)

Tourism may have a complex relationship to a host culture, sometimes reducing culture to a commodity. Some scholars have pointed to positive aspects of tourism (Jack & Phipps, 2005), as at least one widely available means for cross-cultural contact. The TED talk on tourism by Aziz Abu Sarah argues that tourism can play a positive role in peace-keeping. Tourism, in fact, may lead to activism. Baldwin et al. (2013) give the example of the founding of the TOMS One for One shoe company, which donates a pair of shoes to poor Latin-American families for each pair sold. The founder got the idea and incentive for the company while traveling through Argentina.

Of course the characterizations of "traveler" and "tourist" are not mutually exclusive categories. There are many overlapping and gray areas. But in general, the distinction between traveler and tourist is a matter of orientation. Because travelers are more willing to get out of their comfort zones, they are more likely to experience a greater degree of culture shock. At the same time, the opportunity for personal growth and enrichment is much greater when people visit other cultures as travelers rather than tourists. Culture shock, while difficult, should be welcome as an opportunity for growth and development.

Study Abroad

Culture shock has been studied extensively in connection with study abroad programs (see Kinginger, 2008; Salisbury, An & Pascarella, 2013). Large numbers of students internationally go to study at a university in a different country for a time ranging from a short-term summer or winter program (4 to 6 weeks) to a semester or longer. Students may participate as part of a group, through an exchange program, or independently. The European Erasmus Exchange Program has enabled large numbers of students from European countries to study and receive university credit at other universities in Europe. The kind of experience one has through study abroad varies considerably depending on the manner in which it is organized. Going abroad with a group from one's own culture, and attending special university classes together, limits the exposure to the target culture and its language. Organizing independent study abroad experience is more difficult, as one must arrange oneself for university registration, selection of courses, and housing. In the process, however, one is likely to gain greater socio-cultural competence and more integration into the target culture and language. On the other hand, independent students lack the support system available to groups.

Whether one engages in study abroad independently or as a member of a group, individual disposition/personality and the local context will determine the degree of success and personal satisfaction. Hua (2013) points out that many study abroad experiences result in an increase in oral proficiency in the target language and in intercultural understanding and competence. However, that varies tremendously depending on the individual. One might have the kind of limited exposure described here:

Her daily routine included attendance at required classes, after which she would go immediately to the study abroad center sponsored by her home university where she would stay until closing time, surfing the English language Internet and exchanging emails and Instant Messages with her friends and family in the U.S. Outside of service encounters, framed in various ways in her journal as threats to her well-being, she made little effort to engage speakers of French, limiting her use of the language to her courses. (Kinginger & Belz, 2005, p. 411)

In fact, the issue of technology in study abroad is controversial. Some have advocated a restricted use of technology while abroad, so as to maximize real-life contact with the members of the target culture (Doerr, 2013). Some programs go so far as to forbid use of phones while participating in the program (Godwin-Jones, 2016). On the other hand, online access to home communities can be a tremendous help in psychological adjustment and in recovering from culture shock. Maintaining a blog, diary, or reflective journal provides a mechanism for sharing the experience and reflecting on what one discovers, as described in the last section of this chapter.

In addition to study abroad, there are other avenues for university-age students to have meaningful longer-term encounters with a foreign culture. There are opportunities to engage in volunteer services abroad, through government agencies, NGOs, or religious groups. One method that has a long history, particularly in Europe, is to serve as an "au pair", living with a host family and helping with childcare and other light domestic work. Working abroad in other capacities is possible as well, although finding appropriate jobs and obtaining necessary work permits, depending on the country, may be difficult. All these options carry with them the advantage over being a tourist or student in that they tend to offer more complete integration into the everyday life in the foreign country. Living with a host family or entering into a working environment automatically supplies contacts with members of the culture. Particularly attractive are internships abroad, which, in addition to supplying cultural and work experience, offer the possibility of future employment.

Contributors and Attributions

Intercultural Communication for the Community College , by Karen Krumrey-Fulks. Provided by LibreTexts. License: CC-BY-NC-SA

Language and Culture in Context: A Primer on Intercultural Communication , by Robert Godwin-Jones. Provided by LibreTexts. License: CC-BY-NC

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• Ann Glob Health
• v.87(1); 2021

Resiliency, Stress, and Culture Shock: Findings from a Global Health Service Partnership Educator Cohort

Dr. kiran mitha.

1 Seed Global Health, Boston, MA, US

2 David Geffen School of Medicine at UCLA, Los Angeles, CA, US

Sadath Ali Sayeed

3 Harvard Medical School, Cambridge, MA, US

Maria Lopez

4 Formerly affiliated with Seed Global Health, US

Associated Data

Background:.

Global health field assignments for medical and nursing professionals include a wide variety of opportunities. Many placements often involve individuals practicing in settings very different from their home environments, relying on their professional experience to help bridge cultural and clinical divides.

Objectives:

There is limited information about the individual factors that might lead to successful longer-term global health experiences in non-disaster settings. In this paper, we report on one cohort of health professionals’ experiences of culture shock, stress, and resiliency as volunteers within the Global Health Service Partnership (GHSP), a public-private collaboration between Seed Global Health, the US Peace Corps, and the US Presidents Plan for Emergency Aids Relief (PEPFAR) that placed American medical and nursing educators in five African countries facing a shortage of health professionals.

Using the tools of Project PRIME (Psychosocial Response to International Medical Electives) as a basis, we created the GHSP Educator Support Survey to measure resiliency, stress, and culture shock levels in a cohort of GHSP volunteers during their year of service.

In our sample, participants were likely to experience lower levels of resiliency during initial quarters of global health placements compared to later timepoints. However, they were likely to experience similar stress and culture shock levels across quarters. Levels of preparedness and resources available, and medical needs in the community where the volunteer was placed played a role in the levels of resiliency, stress, and culture shock reported throughout the year.

Conclusion:

The GHSP Educator Support Survey represented a novel attempt to evaluate the longitudinal mental well-being of medical and nursing volunteers engaged in intense, long-term global health placements in high acuity, low resource clinical and teaching settings. Our findings highlight the need for additional research in this critical area of global health.

Introduction

Global health field assignments for medical and nursing professionals include a wide variety of opportunities. Many placements often involve individuals practicing in settings very different from their home environments, relying on their professional knowledge to help naturally bridge cultural and clinical divides. Academic institutions and non-governmental organizations have increasingly invested resources in preparing healthcare professionals for the demands of working internationally, yet many of these resources are geared toward trainees in short-term immersion experiences, rather than professionals embedded in local communities for prolonged periods of time [ 1 , 2 , 3 , 4 , 5 , 6 ]. A robust body of literature has previously described the negative mental health outcomes of individuals working long-term in disaster relief settings such as PTSD, depression, and anxiety [ 7 , 8 , 9 ]. Few studies, however, have evaluated individual factors that might lead to successful long-term global health experiences in non-disaster settings.

Culture shock is a term often used to encompass the feelings of anxiety or discomfort a person experiences in an unfamiliar social environment [ 10 , 11 , 12 ]. The “stage theory” of culture shock includes a five-stage model: honeymoon, frustration, adjustment, acceptance, and reentry. A study of culture shock in social workers placed within rural communities in Canada determined the temporal progression through the five stages and demonstrated a curvilinear relationship between lack of well-being (culture shock) and time, with the lowest well-being at month 6 of placement and return to baseline well-being at month 12 [ 13 ]. While culture shock is commonly reported during global health placements [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ], this curvilinear relationship has not been documented in long-term medical volunteers.

In addition to stress from cultural unfamiliarity, healthcare providers experience work-related stress that can significantly impact their well-being. Stress may lead to negative clinical consequences, such as medical errors, compassion fatigue, and unprofessionalism [ 20 ]. Stress can also lead to negative personal consequences, such as chronic fatigue, substance abuse, mental distress, and suicidal ideation [ 21 , 22 , 23 , 24 ]. This can be particularly heightened in settings where individuals are physically separated from their usual sources of support – friends, family, and community in their home countries.

A growing body of literature has evaluated the ability of resilience to counterbalance stress and burnout among healthcare workers. Resilience refers to an individual’s ability to overcome adversity and is a multifactorial construct that varies based on characteristics such as age, gender, time, and context [ 25 , 26 , 27 ]. Two areas previously identified as particularly challenging for healthcare workers are working in areas of resource deprivation and working in remote or rural areas, both of which apply to many settings where international healthcare workers are deployed [ 28 ]. Importantly, resilience is not a static internal quality but can be improved or worsened by environment. Studies of disaster relief workers have shown that contextual factors that improve resiliency may include pre-departure training, team-building efforts, in-country support and recognition, and formal re-entry assistance [ 29 ].

In this paper, we report on one cohort of health professionals’ experiences of culture shock, stress, and resiliency as volunteers within the Global Health Service Partnership (GHSP). GHSP was a public-private collaboration between Seed Global Health, the US Peace Corps, and the US Presidents Plan for Emergency Aids Relief (PEPFAR) that placed American medical and nursing educators in five African countries facing a shortage of health professionals between 2013–2018. Characteristics of the Global Health Service Partnership (GHSP) program included immersion into moderate to high acuity clinical settings, responsibilities of caring for a high volume of patients while providing trainee education, language differences, frequent limitations in available medical and human resources, diagnostic unfamiliarity with local diseases, and different hierarchical structures for clinical personnel.

During the initial years of the GHSP program, multiple survey tools were developed to understand areas of needed programmatic support and quality improvement for the unique circumstances of practicing medical and nursing educators. In 2016, we aimed to combine these tools with validated questionnaires to specifically assess resiliency, stress, and culture shock. Based on pilot survey data and internal consensus, we chose to evaluate individual pre-departure preparation, previous clinical and teaching experience in both underserved domestic and international settings, familial circumstances, and resource variability across placements as unique factors of the GHSP experience.

Concurrently, an ongoing multi-institutional study called Project PRIME (Psychosocial Response to International Medical Electives) was developed by the Midwest Consortium of Global Child Health Educators in 2015 to evaluate medical trainee experiences during short-term global health electives around readiness, stress, and culture shock [ 30 , 31 , 32 ]. It included previously validated tools—the Connor-Davidson Resilience Scale (CD-RISC 10) to measure resiliency, the Perceived Stress Scale (PSS) to measure stress, and a modified version of the “Culture Shock Profile” questionnaire to evaluate culture shock. With permission, we adapted the validated tools from the PRIME protocol with our existing GHSP questionnaires and formulated the GHSP Educator Support Survey.

In July 2016, 70 educators were deployed to partner sites in Liberia, Malawi, Swaziland, Tanzania, or Uganda for a period of one year and all were initially invited to participate in this study. The GHSP Educator Support Survey consisted of five surveys shared with GHSP educators before, during, and after their service. The first survey (pre-service) was administered to educators during their orientation week in Washington DC, with the following three surveys (Q1, Q2, Q3) administered quarterly to volunteers during their in-country placements. The final survey (post-service) was administered 3 months after completing their service ( Figure 1 ). Quarterly surveys were selected in order to capture multiple points in the year-long placement and progression through the stages of culture shock without putting undue survey burden on GHSP educators. Surveys were administered electronically, and all data was de-identified. Quarterly response rates varied from 54–69%, with the exception of the post-service survey, which had a response rate of 39% ( Figure 1 ). Data was cleaned and analyzed using SPSS.

Survey timeline and participant responses.

Although frequencies and means are reported for all survey responses, statistical analyses were conducted only for individuals who completed all five surveys (n = 12) and who had scores for the Resiliency, Stress, and Culture Shock Profile scales for all timepoints.

Sample demographics and professional characteristics

The majority of respondents to all five surveys were nurses (67%), similar to the breakdown between nurse and physician educators in the overall GHSP cohort. In addition, half of respondents were married or partnered volunteers (50%), with the majority of spouses/partners accompanying educators to their country of service (67%). Members of the sample group were more likely to have children above the age of 18 (58%), with 8% of respondents with children under 18, and 33% of respondents without children. Most were not immigrants or children of immigrants to the US and spoke only one language. The majority had not previously visited their country of placement and did not know the local language spoken at their sites ( Table 1 ).

Key sample and overall cohort demographics.

* n = 6. ^ n = 16. ** n = 46.

In their last position before becoming a GHSP educator, the majority of participants (58%) worked in high acuity settings (inpatient or emergency) and were responsible for clinical and/or classroom teaching (75%). Most participants had previous experience working in low-resource settings domestically (83%), although a smaller percentage had clinical experience in an international setting (25%) ( Table 1 ).

The Connor-Davidson Resilience Scale (CD-RISC 10) consisted of a series of ten statements measuring agreement on areas such as ability to adapt to changes, coping with stress, staying focused and being able to handle life’s difficulties. Possible agreement options range from 0 (Not true at all) to 3 (Often true). Answers were then summed to generate a resiliency score, with possible scores ranging from 0 to 30 points. Participants with higher scores are said to have higher resiliency. Participant’s resiliency levels were assessed across all five surveys.

For the subset of participants who completed all five surveys, resiliency score averages stayed mostly the same during service, dipping slightly in Q1, but increasing steadily thereafter, with the highest resiliency scores being reported during the post-test ( Figure 2 ).

Average resiliency scores across time, sample group.

For this group, however, there were statistically significant differences across medians for resiliency ( Figure 3 ). Resiliency scores in Q1 (Mdn = 27) were statistically significantly lower than in Q3 (Mdn = 28, Z = –2.063, p = 0.039) and in the post-departure timepoint (Mdn = 28.5, Z = –2.541, p = 0.011). In addition, Q2 Resiliency scores (Mdn = 26) were statistically significantly lower than Post Resiliency scores (Mdn = 28) ( Z = –2.162, p = 0.031).

Resiliency score medians across time, sample group.

The Perceived Stress Scale (PSS) consisted of a series of ten questions, assessing how often participants have felt able to cope effectively with stress in the recent past. Agreement options range from 0 (Never) to 4 (Very often). Answers are then summed to generate a stress score, with possible scores ranging from 0 to 40, with higher scores indicating higher stress levels. Participant’s stress levels were assessed across all five surveys.

Overall, the average stress score across timepoints for the subset of participants who completed all five surveys was 11.66 out of 40. Stress levels for GHSP educators peaked in Q1, and decreased to below average levels in both Q3 and post-service ( Figure 4 ).

Average stress scores across time, sample group.

For this group, no statistically significant differences across assessment time points were found.

Culture shock

The Culture Shock Profile Questionnaire measured the intensity with which participants experienced a series of 33 positive and negative feelings. The intensity of the feeling was measured from 0 (None) to 3 (Great). Answers were then summed to generate a culture shock score, with possible scores ranging from 0 to 99. The higher the scores, the more culture shock the participants experienced. Culture shock was measured every quarter once participants were in their placement (Q1–Q3) and once participants finished their service and left their service site (post) to assess for reverse culture shock.

Overall, culture shock score averages for the subset of participants who completed all five surveys were highest in Q2, decreasing in Q3 and increasing slightly again during the post-service survey ( Figure 5 ).

Average culture shock scores across time, sample group.

For this group, however, no statistically significant differences were found across the assessment time points.

On sub-analysis, significant differences in the levels of culture shock were found by participants during Q1, based on self-reported levels of feelings of preparedness for their teaching role during their GHSP year during the pre-test survey (χ2(2) = 6.317, p = 0.042). The median Q1 culture shock score for the group that reported feeling somewhat prepared was 27, while the median culture shock score for the group that reported feeling very prepared was 11.

Associations

Correlation analyses were conducted using data from the subset of participants who completed all five surveys to determine if there were any significant associations between educator characteristics and other variables such as resiliency and culture shock scores.

Self-reported levels of preparedness at the predeparture timepoint correlated with resiliency in multiple quarters (Q2 and Q3). Low levels of preparedness at the predeparture timepoint correlated with high levels of culture shock throughout the year and even after their return to the US. Respondents who felt overwhelmed by the medical needs in their community reported higher levels of stress and culture shock across quarters (Q1 and Q3) as well as lower levels of resiliency (Q1, Q2, post). Educators with sufficient teaching resources felt higher levels of stress to provide adequate education to their students across quarters (Q1–Q3) compared to educators without sufficient teaching resources. Higher resiliency levels across the year correlated with respondents feeling fully reintegrated in their home culture on their return to the US ( Table 2 ).

Correlation analyses results, sample group.

The GHSP Educator Support Survey represented a novel attempt to evaluate the longitudinal mental well-being of medical and nursing volunteers engaged in intense, long-term global health placements in high acuity, low resource clinical and teaching settings. Given the competing professional demands of work and challenges around internet connectivity, our response rate for completing all 5 surveys was low (12 out of 70 participants). Thus, our results must be interpreted with caution. Those educators who may have been experiencing higher levels of stress or culture shock may have been less likely to respond to all 5 surveys, leading to disproportionately positive results in our response sample.

In our sample, participants were likely to experience similar resiliency, stress, and culture shock levels across quarters. This may be due to the limited sample size of the respondents, where average scores may not be reflective of individual variations. The median resiliency scores did decrease during the initial quarters of service, likely reflecting the period of adjustment of individuals to their new professional roles and environment. There may also be robustness of these parameters in the global health volunteer population, which may indicate a potential value of using these tools to assess baseline levels of stress and resiliency as part of the selection process for global health placements. Respondents in our sample had overall high levels of resiliency across timepoints (average 26.4 out of 30), low levels of stress (average 11.66 out of 40), and low levels of culture shock (23.2 out of 99).

Another possible signal from our study suggests the value of adequate self-preparation prior to embarking on long-term global health placements. Resiliency positively correlated to self-reported level of preparedness at the pre-service survey timepoint. Self-preparation was, in addition to the formal 1-month orientation included as part of the GHSP program. This suggests that those individuals with high levels of self-motivation to engage in self-study may fare better during their global health deployments.

Respondents who felt overwhelmed by the medical needs in their community reported higher levels of stress and culture shock across quarters as well as lower levels of resiliency. Although global health placements often prioritize settings with high medical need, additional research needs to be done to determine what factors in the medical setting may specifically impact resiliency. Interestingly, those individuals with sufficient teaching resources also reported increased stress to provide medical education, potentially implying that in settings where educational resources have been prioritized, there is added pressure for educators to perform at a high level.

Lastly, global health programs may benefit from an intentional process for professional reintegration on the completion of deployment, particularly for those individuals who struggle during their placement. Higher resiliency levels across the year correlated with respondents feeling fully reintegrated in their home culture on their return to the US, potentially implying that those with lower resiliency did not reintegrate fully on return to the US.

Our findings highlight the need for further structured study on how global health experiences impact the mental well-being of medical and nursing professionals. Future efforts should also be directed toward better understanding factors that best support healthcare workers in settings that can be anticipated to generate culture shock, stress, and test professional and personal resiliency.

Additional Files

The additional files for this article can be found as follows:

Appendix 1.

Table 3. Additional statistically significant Pearson correlations.

Appendix 2.

Survey tools.

Acknowledgements

The authors would like to thank the following people for their instrumental contributions and support as we developed this study: Elizabeth Cunningham (Massachusetts General Hospital), Katelyn Fleming (Ariadne Labs), Clelia Anna Mannino (Seed Global Health), and Laura Foradori (Health Resources and Services Administration, Health and Human Services). The authors would also like to thank the members of the Midwest Consortium of Global Child Health Educators ( sugarprep.org ) and affiliates who developed and shared their research protocol and assessment tools currently being used for their ongoing Project PRIME study involving medical trainees (Psychosocial Response to International Medical Electives). The Project PRIME protocol and assessment tools were directly adapted for use in our study. The Project PRIME principal investigator is Nicole St Clair (University of Wisconsin School of Medicine & Public Health), and other study site leads include the following people: Denise Bothe (Case Western Reserve University), Chuck Schubert and Stephen Warrick (Cincinnati Children’s Hospital Medical Center), Jennifer Watts (Children’s Mercy Hospitals & Clinics), Megan McHenry (Indiana University School of Medicine), Stephen Merry (Mayo Clinic College of Medicine and Science), Vanessa McFadden and Samantha Wilson (Medical College of Wisconsin), Mike Pitt, Stephanie Lauden, and Risha Moskalewicz (University of Minnesota), James Conway and Sabrina Butteris (University of Wisconsin School of Medicine and Public Health) and Elizabeth Groothuis (Northwestern University Feinberg School of Medicine), all accompanied by additional site collaborators. For questions related to the ongoing Project PRIME study involving medical trainees, please email [email protected] .

The Global Health Service Partnership has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Peace Corps under the terms of Award No. PC-12-05-001. Additional funding has been provided by Seed Global Health. The author(s) in this publication is/are solely responsible for the analysis reflected in this publication.

Funding Statement

The Global Health Service Partnership has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Peace Corps under the terms of Award No. PC-12-05-001. Additional funding has been provided by Seed Global Health.

Funding Information

Competing interests.

The authors have no competing interests to declare.

Author contributions

All authors had access to the data used in this research study. All authors had a role in analyzing the data collected and in writing this manuscript. The authors in this publication are solely responsible for the analysis reflected in this publication.

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What Causes Culture Shock?

2022, Dilkur Academy

Culture shock can be described as the feelings one experiences after leaving their family or home to live in another cultural or social environment. Many people associate culture shock with extreme changes from one country to another. Still, it can also be experienced closer to home, such as when travelling from one city to another within your own country. Even the most open-minded and culturally sensitive among us are not immune to culture shock. Culture shock isn't a clinical term or medical condition. It's simply a common way to describe the confusing and nervous feelings a person may have after leaving a familiar culture to live in a new and different culture. When you move to a new place, you're bound to face many changes. That can be exciting, but it can also be overwhelming. You may feel sad, anxious, frustrated, and want to go home.

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What Is Culture Shock?

Understanding culture shock, the 4 stages of culture shock, how to overcome culture shock.

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Culture Shock Meaning, Stages, and How to Overcome

Investopedia / Ryan Oakley

Culture shock refers to feelings of uncertainty, confusion, or anxiety that people may experience when moving to a new country or experiencing a new culture or surroundings. This cultural adjustment is normal and is the result of being in an unfamiliar environment.

Culture shock can occur when people move to another city or country, such as when retiring abroad . Culture shock can also occur when people go on vacation, travel in retirement or for business, or study abroad for school. For example, international students studying abroad for a semester in another country may experience a cultural adjustment due to an unfamiliarity with the weather, local customs, language, food, and values.

Although the timing of each person's adjustment process can be different, there are specific phases that most people go through before they adjust to their new environment. Culture shock can be quite stressful and lead to anxiety. However, it's possible to overcome it and grow as a result.

Key Takeaways

• Culture shock refers to feelings of uncertainty, confusion, or anxiety that people may experience when moving to a new country or surroundings.
• Culture shock can occur when people move to a new city or country, go on vacation, travel abroad, or study abroad for school.
• A cultural adjustment is normal and is the result of being in an unfamiliar environment.
• Culture shock is typically divided into four stages: the honeymoon, frustration, adaptation, and acceptance stage.
• Over time, people can become familiar with their new surroundings as they make new friends and learn the customs, leading to an appreciation of the culture.

Culture shock occurs when an individual leaves the comfort of their home and familiar surroundings and moves to an unfamiliar environment. The adjustment period can be fairly intense, particularly if the two locations are completely different, such as going from a small rural area to a large metropolis or moving to another country. People can also experience culture shock when moving from one place to another within the same country.

Typically, no single event causes culture shock, nor does it occur suddenly or without reason. Instead, it gradually builds from a series of incidents, and culture shock can be difficult to identify while struggling with it.

The feeling is particularly intense at the beginning and can be tough to overcome. It's important to remember that the cultural adjustment usually dissipates over time as a person becomes more familiar with a place, the people, customs, food, and language. As a result, navigation of surroundings gets easier, friends are made, and everything becomes more comfortable.

The adjustment process due to culture shock can get better over time, leading to growth and an appreciation of the new environment.

Symptoms of Culture Shock

Culture shock can produce a range of symptoms, which can vary greatly from person to person in terms of scope and intensity. These may include:

• Being homesick
• Feeling helpless
• Feeling isolated
• Disorientation
• Lack of concentration
• Irritability
• Sleep or eating disturbances

People who experience culture shock may go through four phases that are explained below.

The Honeymoon Stage

The first stage is commonly referred to as the honeymoon phase. That's because people are thrilled to be in their new environment. They often see it as an adventure. If someone is on a short stay, this initial excitement may define the entire experience. However, the honeymoon phase for those on a longer-term move eventually ends, even though people expect it to last.

The Frustration Stage

People may become increasingly irritated and disoriented as the initial glee of being in a new environment wears off. Fatigue may gradually set in, which can result from misunderstanding other people's actions, conversations, and ways of doing things.

As a result, people can feel overwhelmed by a new culture at this stage, particularly if there is a language barrier. Local habits can also become increasingly challenging, and previously easy tasks can take longer to accomplish, leading to exhaustion.

Some of the symptoms of culture shock can include:

• Frustration
• Homesickness
• Feeling lost and out of place

The inability to effectively communicate—interpreting what others mean and making oneself understood—is usually the prime source of frustration. This stage can be the most difficult period of cultural adjustment as some people may feel the urge to withdraw.

For example, international students adjusting to life in the United States during study abroad programs can feel angry and anxious, leading to withdrawal from new friends. Some experience eating and sleeping disorders during this stage and may contemplate going home early.

The Adaptation Stage

The adaptation stage is often gradual as people feel more at home in their new surroundings. The feelings from the frustration stage begin to subside as people adjust to their new environment. Although they may still not understand certain cultural cues, people will become more familiar—at least to the point that interpreting them becomes much easier.

The Acceptance Stage

During the acceptance or recovery stage, people are better able to experience and enjoy their new home. Typically, beliefs and attitudes toward their new surroundings improve, leading to increased self-confidence and a return of their sense of humor.

The obstacles and misunderstandings from the frustration stage have usually been resolved, allowing people to become more relaxed and happier. At this stage, most people experience growth and may change their old behaviors and adopt manners from their new culture.

During this stage, the new culture, beliefs, and attitudes may not be completely understood. Still, the realization may set in that complete understanding isn’t necessary to function and thrive in the new surroundings.

A specific event doesn't cause culture shock. Instead, it can result from encountering different ways of doing things, being cut off from behavioral cues, having your own values brought into question, and feeling you don't know the rules.

Time and habit help deal with culture shock, but individuals can minimize the impact and speed the recovery from culture shock.

• Be open-minded and learn about the new country or culture to understand the reasons for cultural differences.
• Don't indulge in thoughts of home, constantly comparing it to the new surroundings.
• Write a journal of your experience, including the positive aspects of the new culture.
• Don't seal yourself off—be active and socialize with the locals.
• Be honest, in a judicious way, about feeling disoriented and confused. Ask for advice and help.
• Talk about and share your cultural background—communication runs both ways.

What Is the Definition of Culture Shock?

Culture shock or adjustment occurs when someone is cut off from familiar surroundings and culture after moving or traveling to a new environment. Culture shock can lead to a flurry of emotions, including excitement, anxiety, confusion, and uncertainty.

Is Culture Shock Good or Bad?

Although it may have a seemingly negative connotation, culture shock is a normal experience that many people go through when moving or traveling. While it can be challenging, those who can resolve their feelings and adjust to their new environment often overcome culture shock. As a result, cultural adjustment can lead to personal growth and a favorable experience.

What Is an Example of Culture Shock?

For example, international students that have come to the United States for a study abroad semester can experience culture shock. Language barriers and unfamiliar customs can make it challenging to adjust, leading some students to feel angry and anxious. As a result, students can withdraw from social activities and experience minor health problems such as trouble sleeping.

Over time, students become more familiar with their new surroundings as they make new friends and learn social cues. The result can lead to growth and a new appreciation of the culture for the study abroad student as well as the friends from the host country as both learn about each other's culture.

What Are the Types of Culture Shock?

Culture shock is typically divided into four stages: the honeymoon, frustration, adaptation, and acceptance stage. These periods are characterized by feelings of excitement, anger, homesickness, adjustment, and acceptance. Note that some people might not go through all four phases and might not reach the acceptance phase. They might experience difficulties adjusting, which could create permanent introversion or other forms of social and behavioral reactions.

If you've travelled abroad for a while or moved overseas , you may have experienced a bout of culture shock. Things that people in other places take for granted or habits and customs that they practice may be so foreign to you that they "shock" your system. While this could put an initial damper on your international travels, remember that culture shock can be overcome by being open-minded and accustomed to the way things are done that differ from back home.

Bureau Of Educational And Cultural Affairs. " Exchange Programs ."

Brown University. " Office of International Programs, Culture Shock ."

University of the Pacific. " Common Reactions to Culture Shock ."

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