Moving Beyond Single Racial Identification: Considering Multiracial and Multiethnic Identification in Public Health.

As multiracial and multiethnic youth populations are anticipated to be 11.3% of the U.S. population by 2060, it is essential that public health research and practice find ways to effectively capture and reach these diverse groups. Single racial identification has been a norm in public health practice; however, this method has limitations for capturing the health of multiracial and multiethnic individuals. Drawing on personal experience of the author and multidisciplinary scholarship, this research commentary examines the limitations of single race identification and how this influences the processes of racialization. The author provides important implications for public health research by suggesting more complex and effective ways to capture personal racial identification and racial perceptions and addresses how to reach multiracial and multiethnic groups through public health interventions where individuals might identify with multiple cultural identities.

Self-reported cultural competence among Czech and Slovakian nurses: A comparative correlation study.

AIM: This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic. BACKGROUND: Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses' cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries. METHOD: This study was cross-sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0. RESULTS: The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients' health. Cultural diversity training significantly increases the level of cultural competence in nurses. DISCUSSION: Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.

Cognitive Bias in the Patient Encounter: Part II. Debiasing using an adaptive toolbox.

Cognitive bias may lead to medical error, and awareness of cognitive pitfalls is a potential first step to addressing the negative consequences of cognitive bias (see Part 1). For decision-making processes that occur under uncertainty, which encompass most physician decisions, a so-called "adaptive toolbox" is beneficial for good decisions. The adaptive toolbox is inclusive of broad strategies like cultural humility, emotional intelligence, and self-care that help combat implicit bias, negative consequences of affective bias, and optimize cognition. Additionally, the adaptive toolbox includes situational-specific tools such as heuristics, narratives, cognitive forcing functions, and fast and frugal trees. Such tools may mitigate against errors due to cultural, affective, and cognitive bias. Part 2 of this two-part series covers metacognition and cognitive bias in relation to broad and specific strategies aimed at better decision-making.

Strategies for nursing care of critically ill multicultural patients: A scoping review.

BACKGROUND: In society, people live in a social reality where multiculturalism is an increasingly relevant and prevalent topic in their contexts. Facing this, caring for multicultural patients in an emergency service or intensive care unit setting requires a high level of cultural competence due to the complexity, vulnerability of the patient, rapid changes in hemodynamic status, involvement of the family, their informational needs. OBJECTIVE: To map the strategies for nursing care of critically ill multicultural patients. METHOD: A Scoping Review was conducted following the Joanna Briggs Institute's recommendations, with the research question: What are the strategies for nursing care of critically ill multicultural patients? The study was guided by PRISMA. The research was conducted through the EBSCOHost platform, SciELO, Portugal's Open Access Scientific Repository, the Virtual Health Library and a search in grey literature. This was achieved by combining the descriptors DECS/MESH: cultural competence; critical care; emergency room; intensive care; and natural words: cultural care; nurs* interventions; nurs* strategies; within the time frame from 2012 to 2024. The study screening was performed by three independent reviewers through the reading of titles, abstracts and full texts, applying exclusion criteria. The study results were then subjected to content analysis, from which categories emerged. RESULTS: The selected articles highlight various strategies that contribute to the improvement of nursing care for critically ill multicultural patients, focusing on care practice and cultural diversity training for both nurses and nursing students. CONCLUSION: Nurses with cultural competence possess more knowledge and strategies to provide tailored care for multicultural critically ill patients, thereby enhancing the quality of care delivered and contributing to the humanization of healthcare. RELEVANCE TO CLINICAL PRACTICE: Nurses need to have knowledge of existing strategies for caring for multicultural critically ill patients. PATIENT OR PUBLIC CONTRIBUTION: No direct patient or public contribution to the review.

LGBTQIA+ Cultural Competence in Physical Therapist Education and Practice: A Qualitative Study from the Patients' Perspective.

OBJECTIVE: The purpose of this study was to explore the experiences of cultural competence and humility among patients of the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community in physical therapy. Researchers sought to understand the perspectives of adults over 18 years old who have received physical therapy and identify as a member of the LGBTQIA+ community. METHODS: A phenomenological qualitative approach was utilized for this study. Patients were recruited through social media and LGBTQIA+ advocacy organizations across the United States. Twenty-five patients agreed to participate in the study. Focus groups and individual interviews were conducted using a semi-structured interview guide informed by Campinha-Bacote's domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, discussions, thoughts, perceptions, and opinions. RESULTS: Three central themes and subthemes emerged from the data and were categorized according to cultural acceptance (societal impact, implicit and explicit bias), power dynamics between the in-group and out-group (out-group hyperawareness of their otherness), and participant solutions (policy, training, education). CONCLUSION: An LGBTQIA+ patient's experience is influenced by the provider cultural acceptance, and the resulting power dynamics that impact LGBTQIA+ patients' comfort, trust, and perceptions of care. Enhanced patient experiences were found more prevalent with providers that possessed elevated levels of education or experience with this community, supporting Campinha-Bacote's assumption that there is a direct relationship between level of competence in care and effective and culturally responsive service. IMPACT: Awareness of the underlying issues presented in these themes will assist in the development of effective solutions to improve LGBTQIA+ cultural competence among physical therapists and physical therapist assistants on a systemic level.

Ecological predictors of cultural competence among nurses in the neonatal intensive care unit: A cross-sectional descriptive study.

Active migration and globalization have led to increased opportunities for critical care nurses to care for patients from diverse racial and cultural backgrounds. This study thus aimed to identify the individual, interpersonal, and organizational factors affecting cultural competence levels among neonatal intensive care unit (NICU) nurses based on an ecological model. This was a cross-sectional descriptive study that included 135 NICU nurses in South Korea. A hierarchical multiple linear regression analysis was conducted using the proposed ecological model, and a regression model for each of the four subdomains of cultural competence was constructed and compared. NICU nurses' cultural competencies were influenced not only by the "necessity of multicultural education" and "ethnocultural empathy" at the individual level but by the "hospital's readiness and support for cultural competencies" at the organizational level. To promote the cultural competence of nurses in critical care settings, environmental and organizational support should be improved, along with developing strategies that focus on nurses' individual characteristics. It is also necessary to investigate the "intersectionality" of the effects of individual and environmental factors on cultural competence.

Challenges and Opportunities for Implementing Diversity Competence in a Medical Education Curriculum: A Qualitative Study of Perceptions Among Students and Teachers.

OBJECTIVES: Medical education is under continuous pressure to introduce new curriculum content to ensure that physicians possess the competences that the population needs. Diversity competence (DC) is a relatively new area within medicine, challenging the existing curriculum. Frameworks and guidelines have been developed to provide support and assistance to educators in integrating DC into medical programs. However, integrating DC into curriculum has proven difficult and is therefore still not included in many European medical programs. The purpose of the study is therefore to identify the challenges and opportunities for implementing DC including a focus on migrant and ethnic minorities in a medical education program. METHODS: From November 2-20, 2020, focus group discussions with medical students, junior physicians and course leaders were conducted. The participants were recruited via Facebook, newsletters, and emails. Two interview guides were developed and used as guidance for topics to be discussed. The focus group discussions were conducted partly physically and partly digitally. The interviews were transcribed and were analyzed using thematic analysis. RESULTS: Three main challenges and opportunities were identified across the focus groups. Challenges: (i) a disparaging discourse about humanistic and social disciplines within the curriculum, (ii) limited levels of DC among teachers, and (iii) need for institutional support. Opportunities: (i) a clear interest in strengthening teachers' DC levels, (ii) incentives for improving the image of humanistic and social medicine, and (iii) relevant courses for implementing DC. CONCLUSION: Our results showed that action in this area is needed. The themes identified indicated that there are within the curriculum many opportunities to implement DC, but they also illuminated the challenges. The results suggested both a need for focusing on individual competences for medical teachers and students, and also for organizational change and support in favor of DC training.

The Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings.

Although suicide prevention trainings (SPT) have been a standard approach for suicide prevention for years, researchers have noted a need for more clarity in the definition of core competencies for SPTs, particularly in the areas of diversity and culture. Recent research has identified key theoretically- and empirically-based cultural considerations for suicide prevention, but translation is needed to infuse these standards for culture-related competencies into SPTs. This study performed a systematic literature review with a thematic synthesis analytic approach to establish a set of curricular guidelines for infusion of cultural considerations into SPTs. The study also examined the extent to which existing community trainings already incorporate cultural components. Based on the thematic synthesis of 39 SPT studies from 2010 to 2020 and seminal reviews of the cultural and suicide literature, results identified three overarching categories of cultural curricular competencies (suicide knowledge and awareness, suicide intervention skills, and curriculum delivery) and 14 core cultural curricular subthemes for community trainings (e.g., culturally informed risk factors and warning signs, systemic inequities, etc.). These three categories with 14 core cultural curricular competencies comprise the Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings. The majority of trainings (62%) included five or less out of 14 total possible core cultural competencies in their training curricula, pointing to insufficient integration of cultural components in existing community trainings. This study's research-based guideline establishes a culture-inclusive framework to strengthen content and approach of community trainings and suicide prevention across cultural groups.

Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings.

Ethnic disparities in stillbirth exist in Europe and suboptimal care due to miscommunication is one contributing cause. The MAMAACT intervention aimed to reduce ethnic disparity in stillbirth and newborns' health through improved management of pregnancy complications. The intervention encompassed training of antenatal care midwives in cultural competencies and intercultural communication combined with health education materials for the expecting parents about symptoms of pregnancy complications. The evaluation consisted of a qualitative in-depth implementation analysis and a process evaluation embedded in a cluster randomized trial including 19 of 20 maternity wards in Denmark. In this article, the findings from the different evaluation perspectives are integrated. The integration follows the principles of realist evaluation by analyzing to what extent the MAMAACT activities were generating mechanisms of change in interaction with the context. The integration analysis shows that the health education materials in the MAMAACT intervention contributed to heightened health literacy concerning pregnancy complications among pregnant women. Additionally, the training of midwives in cultural competency and intercultural communication raised awareness among midwives. Nonetheless, the exclusive emphasis on midwives and the inflexibility in care provision hindered them from changing their communication practices. To enhance the cultural competence in maternity care, it is essential to implement more comprehensive initiatives involving healthcare professionals in maternity care at all levels, from pregraduate to postgraduate. Adequate interpreter services and management support should also be ensured. Currently, the Danish antenatal care system faces challenges including inadequate information transfer between healthcare sectors, insufficient differentiation of care, and inflexibility in midwife scheduling. This results in a lack of responsiveness to the individual needs of women with immigrant backgrounds, potentially reproducing health inequities.

Access to the Health Care System of Undocumented Moroccan Migrant Slum Dwellers in Southern Spain: A Qualitative Study.

Spain has grown economically due to the recent boosts in the industrial sector, the agricultural sector, construction and services. Those who carry out agricultural tasks are mainly undocumented immigrants living in marginal neighborhoods. OBJECTIVES: to know the perception of undocumented Moroccan migrants living in marginal neighborhoods regarding access to the Public Health System. METHODS: A qualitative method with a phenomenological approach was used to get closer to the experience of the participants in the study. In this work, 24 semi-structured interviews were conducted following a guide with a set of open questions to facilitate an in-depth discussion of the topics of interest. The participants were given an informed consent form, which guaranteed anonymity and confidentiality regarding the information obtained. For this, codes were used to identify them. The data were stored, managed, classified, and organized with the ATLAS-ti 9 software. RESULTS: access and use of health services by the immigrants in the study was difficult due to communication problems related to language and culture, the discriminatory attitude and lack of cultural competence of health personnel, and the location of the neighborhoods (which were marginal far from urban centers), as well as the lack of transportation to health centers. CONCLUSIONS: it is an ethical imperative of the Health System to offer greater attention to the population in situations of extreme vulnerability, implement intercultural mediators and train health professionals in cultural competence.

Cultural topics with clinical implications needed in the dental curriculum to develop intercultural competence: A systematic review.

OBJECTIVE: To identify cultural topics with clinical implications to be incorporated into the dentistry curriculum to develop Intercultural Competence. METHODS: Systematic review with PRISMA criteria that exported 216 articles from the Web of Science, Scopus, and SciELO databases from 2012 to 2022, of which 40 were selected. The inclusion criteria were theoretical and empirical scientific articles, of quantitative, qualitative, or mixed methods nature, on cultural topics. RESULTS: The data analysis allowed the organization of information into four cultural topics: Development of professional intercultural self-awareness, Individual, family, and cultural implications, Construction of intercultural therapeutic relationships, and Specific clinical aspects, each with particular contents to be developed in the dentistry curriculum. However, some clinical issues have yet to be explored in-depth, leaving research possibilities open to all disciplines in dentistry. Additionally, it is necessary to analyze the cultural bias in the discussion and conclusion of some reviewed articles, as they were conducted from an ethnocentric perspective. Thus, peer reviewers of scientific journals and researchers in these topics must have appropriate training in Intercultural Competence. CONCLUSIONS: This review provides a guide and pedagogical sequence of the cultural topics that should be incorporated into the dentistry curriculum to achieve Intercultural Competence, it also highlights a wide range of relevant aspects to consider in establishing an adequate therapeutic relationship. Explicit accreditation criteria contribute to the establishment of Intercultural Competence in the curricula; however, in countries that lack regulations, there is a moral and ethical duty to incorporate the subject so that the future professional can manage and establish inclusive healthcare.

A concept of "cultural competence" among public health nurses in Japan.

OBJECTIVES: To clarify the conceptual structure of "cultural competence (CC)" among Japanese public health nurses (PHNs), to enhance culturally appropriate support. METHODS: A modified grounded theory approach (M-GTA) was used. A total of 11 municipal PHNs participated in this study. Data were collected through semistructured interviews. Interviews were audiotaped and transcribed. A comparative analysis was performed using M-GTA. RESULT: Five categories were identified. Japanese PHNs supported foreign residents while (1) maintaining a sincere attitude with curiosity and humility toward others regarding CC; (2) deepening their realization of issues arising from awareness of one's own and other cultures; (3) developing their knowledge about clients' cultures and the surrounding environments; and (4) mastering the skills of building a relationship with clients while creating supportive systems surrounding them. As they gained more experience in supporting foreign residents, as indicated in the above categories, their cultural competence grew, allowing them to (5) gain experience while encountering individuals without holding stereotypes and prejudice. CONCLUSIONS: The concepts of CC that emerged are based on cultural humility and are cultivated through supportive activities. The concepts identified in this study can serve as educational guidelines for health nurses and other care providers in Japan.

Evaluating the cross-cultural competence instrument for healthcare professionals (CCCHP) among nurses in Okinawa, Japan.

BACKGROUND: To provide better quality healthcare services to patients with different linguistic and cultural backgrounds, the cross-cultural competence of medical professionals is important. However, assessing and improving the cross-cultural competence of healthcare professionals is difficult in Japan, as there is no standardized scale to measure the competence. This study's purpose was to translate the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP), which was developed and used in Europe, and to examine its reliability and validity among Japanese nurses. METHODS: During June and July 2021, nursing staff were invited to take web- and paper-based surveys in Okinawa Japan. The CCCHP (five-factor model with 27 items across motivation, attitude, skills, emotion, and knowledge) was translated using a combination translation method, and a five-point Likert scale was used for responses. Exploratory and confirmatory factor analyses and known-group method were used to examine structural validity, while Cronbach's alpha coefficient was used to test reliability. RESULTS: A total of 294 responses were analyzed; 77.2% had more than five years of experience. Since the fit index indicated that the five-factor model was not a good fit, it was modified to a four-factor model (J-CCCHP24) by moving three variables, removing the knowledge factor, and using the error covariance of the variables. The fit index after the modification was improved to comparative fit index (CFI) = 0.92, Tucker-Lewis index (TLI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, and standardized root mean square residual (SRMR) = 0.06, and Cronbach's alpha was 0.85. The mean scores of J-CCCHP24 were significantly higher in the group with a history of overseas travel, higher foreign language skill, training in intercultural care, experience of foreign patient care, and intercultural interactions outside the workplace than in the group without these characteristics. CONCLUSION: This study confirmed the validity and reliability of the modified Japanese version of the CCCHP (four-factor model with 24 items). The results suggest that the exposure to different cultures on a personal level may help improve nurses' cross-cultural competence. Further refinement of this scale for practical use would encourage the implementation of necessary countermeasures to improve the cross-cultural competence of Japanese healthcare professionals.

The Importance of Cultural Awareness in the Management of Heart Failure: A Narrative Review.

Heart failure is a commonly encountered clinical syndrome arising from a range of etiologic cardiovascular diseases and manifests in a phenotypic spectrum of varying degrees of systolic and diastolic ventricular dysfunction. Those affected by this life-limiting illness are subject to an array of burdensome symptoms, poor quality of life, prognostic uncertainty, and a relatively onerous and increasingly complex treatment regimen. This condition occurs in epidemic proportions worldwide, and given the demographic trend in societal ageing, the prevalence of heart failure is only likely to increase. The marked upturn in international migration has generated other demographic changes in recent years, and it is evident that we are living and working in ever more ethnically and culturally diverse communities. Professionals treating those with heart failure are now dealing with a much more culturally disparate clinical cohort. Given that the heart failure disease trajectory is unique to each individual, these clinicians need to ensure that their proposed treatment options and responses to the inevitable crises intrinsic to this condition are in keeping with the culturally determined values, preferences, and worldviews of these patients and their families. In this narrative review, we describe the importance of cultural awareness across a range of themes relevant to heart failure management and emphasize the centrality of cultural competence as the basis of appropriate care provision.

Linking Immigrants with Nutrition Knowledge (Project LINK): An Innovative Approach to Improve Cultural Competence in Dietetic Education.

Linking Immigrants with Nutrition Knowledge (Project LINK) was a service-learning cultural competence training programme completed by undergraduate dietetic students enrolled in the University of Saskatchewan's (USASK) nutrition and dietetic programme.This paper evaluates the impact of participation in the programme on students' cultural competence. We conducted a cross-sectional survey and qualitative analysis of reflective essays of 107 participants of Project LINK from 2011 to 2014. Cumulative logistic regression models assessed the impact of the intervention on students' cultural competencies. The Akaike information criterion compared models and Spearman correlation coefficient identified possible correlation among pre- and post-intervention data points. Student reflective essays were analyzed by inductive thematic analysis.All cultural competencies improved comparing pre- and post-participation in Project LINK. Odds of increasing one level of student knowledge were 110 times of that prior to Project LINK. Comparing student competencies before and after Project LINK, the odds of increasing one level of students' skills were six times greater, five times greater for increasing one level of students' ability to interact or encounter, and 2.8 times greater for increasing one level of students' attitude.The results of this study indicate Project LINK has successfully increased cultural competence and underscores the importance of combining opportunities for practical experience in addition to classroom-based training on cultural competence.

Evaluation of cross-cultural competence among German health care professionals: A quasi-experimental study of training in two hospitals.

Sociocultural diversity in the German health care system is increasingly reflected in multicultural teams and the diversity of patients. To ensure successful collaboration in a multicultural environment and effective care to diverse patients the importance of cross-cultural competence training is growing. There is a lack of evidence-based training approaches for the German health care system, and it is unclear how the theoretical-conceptual promotion of cross-cultural competence can be achieved sustainably. The aim of the study is to evaluate the effectiveness of cross-cultural competence training for German health care professionals. A quasi-experimental evaluation study in two German hospitals was conducted. Cross-cultural competence was examined in an intervention and a control group (n = 196) using the self-reported instrument Cross-Cultural Competence of Healthcare Professionals (CCCHP) and analyzed with SPSS Statistics 25. Cross-cultural training had a cognitive level impact on knowledge, awareness, and attitudes and showed a highly significant reduction in social desirability. On an affective level, cross-cultural motivation and curiosity initially increased at t1 and decreased at t2. Cross-cultural emotion and empathy increased slightly. On a behavioral level, cross-cultural skills decreased after the training. For sustainable effects, cross-cultural training should focus more on practical skills in addition to theoretical content. Training interventions should be long-term. The results show that more needs to be done in the German health care sector to meet the increasing diversity and demands.

Correlates of supportive care needs among Asian Americans with colorectal, liver, or lung cancer from a web-based patient navigation portal intervention: The Patient COUNTS study.

BACKGROUND: Cancer is the leading cause of death among Asian Americans, who often face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied. AIMS: We examined cancer supportive care needs and participant factors correlated with these needs, identified profiles of supportive care needs, and examined whether needs profiles are associated with quality of life among Asian American adults. METHODS AND RESULTS: We recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their supportive need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy. Participants (mean age = 57.6) included 72% males and 62% spoke English less than very well. Older participants (age ≥ 65) and those with annual income <$50K reported higher daily living needs. Men and younger participants (age < 50) reported higher behavioral health needs. We found three clusters displaying distinct cancer supportive need profiles: Cluster 1 (28% of the sample) displayed high needs across all domains; Cluster 2 (51%) had low needs across all domains; and Cluster 3 (21%) had high needs for cancer information and daily living. Cluster 1 participants reported the lowest QoL. CONCLUSION: Cancer supportive care needs among Asian American patients with colorectal, liver, and lung cancer were associated with patient characteristics and QoL. Understanding cancer supportive care needs will inform future interventions to improve care and QoL for Asian American patients with cancer. CLINICALTRIALS: gov Identifier: NCT03867916.

Culture, Cultural Competence, and Clinical Care.

Culture competence is a concept that can be traced back to health care considerations in the 1960s and 1970s, and in particular to nursing education. Critics of the concept have argued that this was not simple a listing of cultural facts, behaviors, and practices, but instead follow a more ethnographic understanding of culture. In this article, I recognize that culture is not simply about the other, but something we all possess, and is also always changing throughout our lives. Understanding and respecting diversity and culture is key to improving services, including lactation support.

Culturally competent respect for the autonomy of Muslim patients: fostering patient agency by respecting justice.

Although Western biomedical ethics emphasizes respect for autonomy, the medical decision-making of Muslim patients interacting with Western healthcare systems is more likely to be motivated by relational ethical and religious commitments that reflect the ideals of equity, reciprocity, and justice. Based on an in-depth cross-cultural comparison of Islamic and Western systems of biomedical ethics and an assessment of conceptual alignments and differences, we argue that, when working with Muslim patients, an ethics of respect extends to facilitating decision-making grounded in the patient's justice-related customs, beliefs, and obligations. We offer an overview of the philosophical contestations of autonomy-enhancing practices from the Islamic tradition of biomedical ethics, and examples that demonstrate a recommended shift of emphasis from an autonomy-centered to a justice-focused approach to culturally competent agency-promotion.

Transcultural nursing: a qualitative analysis of nursing students' experiences in a multicultural context in North-Eastern Namibia.

BACKGROUND: Culture is a fundamental concept in healthcare settings due to the reason that care provided to patients is holistic and encompasses their perspectives on health, which are greatly influenced by the patients' cultures. To prepare culturally competent nursing graduates, it is important to understand the experiences of students on transcultural nursing during clinical practice. However, there are limited studies that have explored experiences of students on transcultural nursing, specifically those located in multicultural societies. In addition, studies focus on experiences of international students who visit with student - exchange programme. Nevertheless, their experiences of transcultural nursing may differ since they are not residents and have limited exposure to transcultural nursing, and therefore cannot be generalized to undergraduate resident students. This study aimed to explore and describe transcultural nursing experiences of nursing students during clinical practice at an intermediate hospital in north-eastern Namibia. METHODS: Descriptive and explorative qualitative designs were used, data were collected via individual interviews from 16 final year nursing students, who were sampled using maximum variation purposive and snowballing sampling. During data collection, an interview guide was used together with audiotape and field notes. Data analysis followed Tesch's eight steps in qualitative coding process. Trustworthiness was ensured using four principles of Lincoln and Guba, Moreover, ethical clearance and permission were granted by research ethics committees from two institutions. FINDINGS: Four main themes emerged as findings of the study are: nursing students' exposure to different cultural practices and beliefs; personal feelings experienced by nursing students during transcultural nursing; challenges experienced by students during transcultural nursing; and nursing students coping mechanisms. CONCLUSIONS: Nursing students had mixed experiences on transcultural nursing which touch on aspects such as exposure to cultural aspects, personal feelings, challenges, and coping mechanisms. These findings are useful in helping nurse educators, clinical mentors, students, and future researchers to understand experiences of students on transcultural nursing. Consequently, assist in enriching transcultural nursing issues in curricula and for adequate preparation of graduates to become culturally competent when providing nursing care.