Cultural competence of nursing educators at medical universities of 2nd regional planning in Iran.

BACKGROUND: One of the facets of nursing care, as a holistic profession, is cultural care. Considering the role of culture in individuals' health behaviors, nurses are recommended to be mindful of cultural care. Since nursing educators should be culturally competent to teach cultural care to students, this study aimed to determine the cultural competence of nursing educators of medical sciences universities in the 2nd regional planning in Iran. METHODS: The current research was a descriptive and survey study framed within Campinha-Bacote's cultural competency model. All nursing educators of universities of medical sciences in the 2nd regional planning of Iran (Tabriz, Urmia, Ardabil, Khoy, Maragheh, Sarab, and Khalkhal) were considered as research units, and the cultural diversity questionnaire for nursing faculties (CDQNE-R) was sent to them. Out of 129 questionnaires sent, 84 were turned back. The data were analyzed by the SPSS 22 software. RESULTS: The results of this study showed that the research participants agreed with the subscales of cultural awareness, cultural knowledge, cultural skill, and cultural desire according to Sealey and Yates' interpretation scale. Also, the research units cast doubts on the cultural encounter subscale. The mean scores of the participants' responses to the questions of every subscale equaled 4.11, 3.52, 3.71, 3.38, and 3.93 for the subscales of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire, respectively. Likewise, the mean scores of participants' responses to the subscales of transcultural educational behaviors and general cultural competence equaled 3.90 and 3.73. CONCLUSIONS: The nursing faculties participating in the present study agreed with the 4 sub-models of Campinha-Bacote cultural care and the presence of cultural competence criteria. Also, the research units had doubts about the cultural encounter subscale. This result means that the research participants were undecided about their level of participation in face-to-face interactions with people from different cultural, racial, and ethnic groups. According to the results of the study, it is important to hold transcultural nursing training workshops and courses to maintain and improve the level of cultural competence of nursing faculties at universities of medical sciences in the 2nd regional planning in Iran.

The development of cultural competences in nursing students and their significance in shaping the future work environment: a pilot study.

BACKGROUND: Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia. METHODS: A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05. RESULTS: The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale "Cultural Knowledge" particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge. CONCLUSIONS: The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers.

Examination of individualised care behaviours and ethnocentrism of nurses caring for refugees: A descriptive and exploratory study.

BACKGROUND: Qualified individualised nursing care should be provided to all communities and ethnic groups with free of ethnocentrism. AIMS: To evaluate nurses' individualised care behaviours and ethnocentric attitudes and predict the relationship between their individualised care behaviours and ethnocentric attitudes. DESIGN: A descriptive and exploratory study. METHODS: This study was conducted with 250 nurses working in a public and two private hospitals in a city, an area with many refugees. Data were collected using the Ethnocentrism Scale and Individualised Care Behaviours Scale. Structural equation model analysis to test hypothetical model and descriptive statistics were used. RESULTS: Nurses working in the private hospitals had a higher individualised care decision control mean score. Those nurses who enjoyed spending time with people from different cultures had lower mean ethnocentrism scale scores, higher individualised care clinical status, personal life and decision control status subscales mean scores compared to other nurses. Mean scores of the individualised care personal life and decision control status subscales of the nurses who followed the literature on transcultural nursing was higher. A significant relationship between the ethnocentrism levels and individualised care behaviours was identified. Accordingly, the ethnocentric attitudes of the nurses negatively affected their individualised care behaviours, and the model established between the two concepts is statistically appropriate. CONCLUSIONS: Nurses who work in private hospitals, receive intercultural nursing education and enjoy spending time with different cultures have higher individualised care behaviours and lower ethnocentrism levels. Ethnocentric attitudes of the nurses negatively affected their individualised care behaviours. Care strategies should be developed that consider the factors that will maximize individualised care practices that minimize ethnocentric behaviours among nurses. IMPLICATIONS FOR THE PROFESSION: Increasing awareness on individualised care behaviours, ethnocentric attitudes and effected factors will contribute to improve of nursing care quality of nurses while giving care to individuals from different cultures.

Nurses' experiences of providing transcultural nursing care to minority patients in Yunnan province: A descriptive qualitative study.

Cultural competency is essential for providing transcultural nursing care. This qualitative study explores nurses' experiences of providing transcultural nursing care to patients from ethnic minority in Yunnan province, China, with the aim of supplementing and enriching previous quantitative research. Yunnan is home to 25 ethnic minorities with the highest proportion (33.1%) of people from ethnic minorities in China. A descriptive qualitative method was used to describe the experiences of 12 nurses. Data were collected in October 2020 through semistructured interviews and analyzed using conventional content analysis methods. Three themes were generated, including limitations of resources to provide transcultural nursing care, challenges in providing transcultural nursing care, and concerns about the quality of nursing care. The results suggest that there is scope for improving cultural competence of nurses in Yunnan through education that would enable them to provide high-quality transcultural nursing care. Training topics could include transcultural knowledge, cultural sensitivity, minority languages, and immersive multicultural experiences. Other suggested improvements include a resource room for transcultural care, the accommodation of religious and dietary needs, and dedicated staff who lead transcultural care in hospitals.

Effects of Transcultural Nursing Education on the Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence of Students.

Purpose: To examine the effect of Transcultural Nursing education on nursing students' Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence.Design: A posttest quasi-experimental study with a control group.Methods: The participants were second year nursing students (n = 125). The experiment group was composed of students who had enrolled in the Transcultural Nursing course (n = 65). The control group consisted of students who did not enroll in this course (n = 60).Findings: The posttest scores of the experiment group in the scales were significantly higher than those in the control group (p < .01).Conclusion: Transcultural nursing course is an effective method to increase the professional values, empathic skills, cultural sensitivity and intelligence of students.

Teaching the Meaning of Culture in a Baccalaureate Nursing Curriculum.

Because culture affects virtually every aspect of life, including health beliefs, customs, and practices, it is imperative that nursing students recognize and value its critical importance to the people whom they will care for as clients/patients. Hence, the notion of culture must be introduced early on in nursing programs and threaded throughout the entire curriculum.

Recruitment of nurses from India and their experiences of an Overseas Nurses Program.

BACKGROUND: Overseas recruitment has been vital to the contribution of staff growth in the National Health Service (NHS). In 2011, high nursing vacancy rates within critical care required that overseas nurses were recruited. The recruited nurses were placed in an Overseas Nurses Program (ONP), a course designed to assist overseas nurses in adapting to the NHS. AIM: To describe the experiences of nurses recruited from India who participated in an ONP. DESIGN: A qualitative, research approach was chosen to gather descriptions of the lived experiences of nurses from India transitioning to London, to work in critical care settings. METHOD: A descriptive qualitative approach was taken using in-depth, semi-structured and audio-taped interviews. They were conducted over a 69-day period (30 November 2012 to 6 February 2013) with 16 nurses from India. The nurses were questioned about challenges, experiences and differences; they were also asked to make suggestions for other nurses undertaking an ONP in the future. Interviews were transcribed verbatim into a formal written style with NVivo10. RESULTS: Eleven females and five males aged 25-33 years who had completed up to four years of university training participated in this study. The themes extracted were autonomy and responsibility, language, culture (food and climate), loneliness and work challenges (ONP and essay writing). Participants identified that they would have benefited if pre-allocated mentors from non-English speaking countries who had previously been through the transition process were available to assist them with their personal and professional integration into a new country. CONCLUSION: Autonomy disparity, language barriers and cultural differences need to be recognised and acknowledged by multi-disciplinary teams, by allowing sufficient time and additional support for non-English nurses undergoing ONPs. RELEVANCE TO CLINICAL PRACTICE: Overseas nurses would benefit from being mentored by another nurse from a similar culture, with a non-English background. It may be feasible for overseas nurses to receive training in cultural competencies to improve disparities.

Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice.

The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.

Nursing in the Mercy Traditions: Engaging Students in the Life of Catherine McAuley.

The Institute of Medicine and the American Association of Colleges of Nursing advise that professional nursing education include development of a high level of cultural competency. A 10-day learning experience to Ireland for nursing students at the University of Detroit Mercy, an independent Catholic university, sponsored by the Sisters of Mercy and the Society of Jesus (Jesuit Fathers), helped them develop a philosophy of Mercy care and build cultural competence. Learning focused on the life of Catherine McAuley, Irish culture, spirituality, social justice, reflective thinking, and a value-centered professional education.

Culturally and linguistically responsive teaching: part I.

As increasing numbers of culturally and linguistically diverse learners are enrolled in nursing programs and employed in nursing service agencies, nurse educators must be aware of their own culture and how it influences their teaching and understand the learning needs of a diverse group of learners. This article offers strategies for nurse educators for being culturally and linguistically responsive while also establishing an inclusive learning environment.

Culturally and linguistically responsive teaching: part II.

This part II of a two-part article about culturally and linguistically responsive teaching provides suggestions for evaluating learners who are culturally and linguistically diverse (CALD) and are often under-represented in nursing education settings.

Educating nurses to provide culturally competent care during disasters.

Health disparities are exacerbated during times of disasters. To decrease health disparities, it is essential that health care providers understand the specific needs, culture, and norms of individuals, groups, and populations in a disaster. Survivors respond and recover from disaster events within the context of their culture and beliefs; therefore, implementing cultural competent interventions for disaster victims is central to providing services and care. This article describes the development, implementation, and evaluation of a continuing education program and academic courses for nurses and nursing students.

Walking in two worlds.

It has been nearly quarter of a century since nursing educator Irihapeti Ramsden wrote the guidelines on cultural safety (Kawa Whakaruruhau), ratified in 1992 and subsequently much revised (most recently in 2011) by the Nursing Council. The Te Puna Hauora Kaupapa Nursing Service at Tauranga Hospital has been in existence for more than 18 years. Despite this, the experiences of Maori nurses described here, and the lack of adoption of truly bicultural nursing services in other parts of the country, indicate far more investment is needed in Maori nursing. What all those working in the health-care system need is the capacity to deliver whanaungatanga models of care, through cultural awareness education, and through the development of cultural competencies.

Cultural competency among nurses with undergraduate and graduate degrees: implications for nursing education.

AIM: To compare the level of cultural awareness, knowledge, skills, and comfort of nurses with undergraduate and graduate degrees when encountering patients from diverse populations. BACKGROUND: Cultural competency is a core curriculum standard in undergraduate and graduate nursing programs. Assessing cultural awareness, knowledge, skills, and comfort among nurses can help identify areas to strengthen in nursing curricula. METHOD: A prospective, cross-sectional, descriptive study design was used. Two thousand surveys were sent to nurses in a southeastern state; 365 nurses participated. RESULTS: Undergraduate-degree nurses scored lower than graduate-degree nurses on cultural knowledge. Scores on cultural awareness, skills, and comfort with patient encounters did not vary between groups. Both groups of nurses reported little cultural diversity training in the workplace or in professional continuing education. CONCLUSION: The findings of this study indicate areas of need for undergraduate and graduate nursing education.

Samoan Philosophy of Nursing: a basis for culturally proficient care and policy.

AIM: To explore nurses' perspectives about the Samoan Philosophy of Nursing, and determine its feasibility for nursing care of Samoans internationally. BACKGROUND: This philosophy is the conceptual cultural framework for nursing law, practice, education and research in Samoa, and was developed by Samoan nurses who recognized the need for guidance to deliver quality, culturally competent and proficient health care. DESIGN: A mixed method study, employing a questionnaire and ethnographic methods. METHOD: The Samoan Philosophy of Nursing Questionnaire sought demographic data and aspects about the philosophy from 95 registered nurse clinicians, administrators and educators throughout Samoa during 2012. Descriptive statistics were used for data analysis. Additionally, 19 focus groups (5-6 participants each) and 19 in-depth interviews were held to further explore these aspects, as well as participant observations. Descriptive statistics were used to analyse quantitative data, and Spradley's ethnographic method was adopted for analysing the qualitative data. FINDINGS: Of 95 questionnaires analysed, 70% of participants reported using the philosophy all the time, and 30% most of the time. They placed a high satisfaction rate, value and importance on this philosophy. From the ethnography, six major themes emerged: valuable framework of learning; conceptual framework for holistic assessment; benchmark for regulating and monitoring practice improving interaction and culturally proficient practice; potential use for Samoans overseas; and maintaining quality health and the dignity of people. CONCLUSION: This first-time study evaluated the Samoan Philosophy of Nursing and adds to nursing knowledge. Findings confirmed its usefulness as a culturally based conceptual framework to facilitate, regulate and monitor education, research and practice for sustainable health outcomes in Samoa, and for Samoans living abroad. IMPLICATIONS FOR NURSING POLICY AND EDUCATION: It is important that Samoans living abroad receive culturally proficient care, but this requires the support of policymakers, nurse leaders and educators so that nurses internationally can access and competently utilize relevant aspects of this philosophy in practice.

Motivation and international clinical placements: shifting nursing students to a global citizenship perspective.

Nursing programs are increasingly offering international clinical experiences as part of nursing curricula. The purpose of this study was to understand what motivates student nurses to take part in these experiences. Related to motivation, student awareness of emerging nursing discourses on global citizenship was also examined. As part of a qualitative study, nine undergraduate nursing students were interviewed about their motivations for choosing a clinical placement to a low-income country. While students appeared to have a sincere desire to make a difference, closer examination of the data revealed that the majority approached their international clinical placement in ways that could be construed as paternalistic to some degree, rather than reflective of broader professional imperatives such as social justice. This finding suggests that additional education preparation may be needed prior to these experiences; global citizenship frameworks may be helpful in shifting perspectives towards a more critical enquiry of global issues.

Cultural safety in New Zealand midwifery practice. Part 2.

Midwives in New Zealand work within a unique cultural context. This calls for an understanding and appreciation of biculturalism and the equal status of Mãori and Europeans as the nation's founding peoples. This paper is the second of two papers that explore the notions of cultural safety and competence. Exploration and discussion take place in the New Zealand context, yet have transferable implications for midwives everywhere. This second paper focuses on midwifery education and practice.

FOCUS on excellence: making a difference through global initiatives.

The Center of Excellence (COE) designation in the category of"student learning and professional development" has hallmarked Regis College as having nursing programs that create environments for students to excel academically, professionally, and personally. As a designated COE nursing program, our efforts have focused on creating and sustaining a curriculum that has a strong enculturation of diversity, with numerous local, regional, national, and international learning experiences. Examples of learning opportunities through global outreach health initiatives are included, demonstrating how the COE designation has provided recognition and led to further opportunities for faculty and students to become involved in health-related activities.

International programs in United States schools of nursing: driving forces, obstacles, and opportunities.

AIM/PURPOSE: To understand the development of international programs in United States schools of nursing from the perspective of driving forces, obstacles, and opportunities. BACKGROUND: Despite increasing philosophical support for international programs, significant obstacles to their development, integration, and sustainability exist in schools of nursing across the United States. METHOD: A National League for Nursing (NLN) survey collected information on the number and type of international programs being offered, with an emphasis on obstacles to integration. RESULTS/FINDINGS: Driving forces for international programs, identified by 487 responding institutions, included valued program outcomes, a global focus, and limited availability of clinical sites. Obstacles, such as cost, safety, and lack of credit toward a major, were identified. CONCLUSION: Suggestions for addressing and overcoming the obstacles are proposed, including the sharing of resources and utilization of the NLN Faculty Preparation for Global Experiences Toolkit. More research is needed to understand the implications for curricula, logistics, development, costs, and sustainability.

Evaluating cultural competence in the clinical practicum.

AIM: The main purpose is to introduce a tool for evaluating the extent of culturally specific care provided for a diverse clientele, the frequency of cultural assessments, and the development of culturally sensitive and professionally appropriate attitudes, values, and beliefs. BACKGROUND: Legal, ethical, and accreditation mandates demand theoretically based, valid, comprehensive tools to assess aspects of culturally specific care; yet no relevant ones existed. METHOD: The Cultural Competence Clinical Evaluation Tool (CCCET) was administered at the end of a second semester medical-surgical nursing course (n = 161). RESULTS: The Content Validity Index (CVI) was 0.91. The reliability coefficients provided evidence for internal consistency. CONCLUSION: Student and teacher ratings were relatively close, suggesting that respondents took the task of CCCET completion seriously and honestly, that cultural competence was a visible theme throughout the course, and that students and instructors worked closely together in the clinical practicum setting to achieve learning objectives (including cultural competence).